HER2在结直肠癌中的表达及其与预后的关系

摘要

背景:结直肠癌(CRC)是常见的消化系统恶性肿瘤,具有高度侵袭性和转移性,病死率高.人表皮生长因子受体2(HER2)在多种肿瘤中存在高表达,可抑制肿瘤细胞凋亡,是肿瘤预后不良的指标之一.目的:研究CRC组织中的HER2表达及其与肿瘤临床病理特征和预后的关系.方法:连续收集2010年2月─2011年2月北京航天总医院118例CRC患者,采用免疫组化染色检测癌组织HER2表达水平,分析其表达与肿瘤临床病理参数和患者预后的关系.结果:CRC组织中HER2表达阳性率为34.7%(41/118),其中高表达18例(15.3%),低表达23例(19.5%).HER2表达与肿瘤浸润深度、淋巴结转移、TNM分期显著相关(P<0.05).HER2表达阴性、低表达、高表达患者随访期内死亡率依次增高,组间两两比较差异均有统计学意义(P<0.05).Cox比例风险模型分析显示HER2是CRC患者预后的独立影响因素(RR=2.134,95%CI:1.172~2.415,P=0.006).结论:HER2高表达与CRC临床分期和患者预后有关,有望成为CRC预后评估的生物学标记物.%Background:Colorectal cancer (CRC)is a common malignant tumor in digestive system with high invasive and metastatic properties and has a high mortality rate. Human epidermal growth factor receptor 2 (HER2)is highly expressed in a variety of tumors and can inhibit tumor cell apoptosis. It is an indicator of poor prognosis in some malignancies. Aims:To study the expression of HER2 and its correlation with clinicopathological characteristics and prognosis of CRC. Methods:A total of 118 patients with CRC admitted from Feb. 2010 to Feb. 2011 consecutively at the Beijing Aerospace General Hospital were recruited. Expression level of HER2 protein in CRC tissue was determined immunohistochemically and its correlations with clinicopathological parameters and prognosis of CRC were analyzed. Results:Immunohisto-chemically,positive staining for HER2 was found in 41 cases of the CRC tissues (34. 7%),of which 18 (15. 3%)were strongly positive and 23 (19. 5%)were weakly positive. There were significant correlations between HER2 expression and depth of invasion,lymph node metastasis and TNM staging of CRC (P < 0. 05). Follow-up study revealed that the mortality rate increased with the increase of intensity of HER2 staining (P < 0. 05). Cox proportional hazard model confirmed that HER2 was an independent prognostic factor in CRC patients (RR = 2. 134,95% CI:1. 172-2. 415,P = 0. 006). Conclusions:High expression of HER2 is correlated with clinical staging and prognosis of CRC,and might be used as a biomarker for prediction of prognosis in CRC patients.