Siewert Ⅱ、Ⅲ型胃食管结合部癌的临床特点及 HER2、SKP2表达

摘要

目的：探讨 Siewert Ⅱ、Ⅲ型胃食管结合部癌（AEG）的临床特点及人表皮生长因子受体2（HER2）、细胞S 期激酶相关蛋白2（SKP2）表达变化。方法选取 SiewertⅡ及Ⅲ型 AEG 患者206例，比较二者的临床特点；应用免疫组化方法检测其 HER2、SKP2表达情况，分析 SiewertⅡ、Ⅲ型 AEG 患者 HER2、SKP2阳性表达与临床病理参数的关系。结果两型 AEG 患者肿瘤大小、淋巴结转移、肿瘤分化程度和 TNM分期比较有统计学差异（P 均＜0．05）。SiewertⅡ型 AEG 患者 HER2、SKP2阳性表达率分别为32．9％、41．2％，SiewertⅢ型 AEG 患者 HER2、SKP2阳性表达率分别为36．3％、55．4％；两组 SKP2阳性表达率差异有统计学意义（P ＜0．05）。SiewertⅡ或Ⅲ型 AEG 患者中，肿瘤直径＜5 cm 与≥5 cm、浸润深度 T1～T2与 T3～T4、高～中分化与低分化、淋巴结转移 N0～N1与 N2～N3之间 HER2阳性表达率有统计学差异（P 均＜0．05）。结论 HER2、SKP2异常表达可促进 AEG 的发生发展， HER2、SKP2表达检测对 AEG 早期诊断及疗效判断有重要作用。%Objective To invesitgate the clinical characteristics and expression of human epidermal growth factor re-ceptor 2 (HER2)and S-phase kinase-associated protein 2 (SKP2)in Siewert Ⅱ and Ⅲ adencarcinoma of gastric esopha-geal junction (AEG).Methods Totally 206 patients with Siewert II or Ⅲ AEG were selected for comparison of the clini-cal characteristics between the two types.The expression of HER2 and SKP2 was detected by immunohistochemistry.The relationships between positive HER2 and SKP2 expression and the clinical pathologic parameters in Siewert Ⅱ and III AEG were analyzed.Results There were statistically significant differences between the two AEG types in tumor size,lymph node metastasis,differentiation grade and TNMstage (all P <0.05).The positive expression rates of HER2 and SKP2 were respectively 32.9% and 41.2% in patient with Siewert II AEG,and 36.3% and 55.4% in patients with Siewert ⅢAEG;there was statistically significant difference in SKP2 positive expression rate between the two groups (P <0.05).A-mong the patients with Siewert II or Ⅲ AEG,there were statistically significant differences in HER2 positive expression rate between those with tumor size <5 cm and ≥5 cm,those with infiltration depth T1 -T2 and T3-T4 ,those with high-moderate and low differentiation,and between those with lymph node metastasis N0-N1 and N2-N3 (all P <0.05).Conclusion Abnormal expression of HER2 and SKP2 could promote the development and progression of AEG,and thus may provide a new approach for early diagnosis and treatment of AEG.