Prognosis of HER2 over-expressing gastric cancer patients with liver metastasis

被引:44
作者
Dang, Hai-Zhen [1 ,2 ]
Yu, Yang [3 ]
Jiao, Shun-Chang [4 ]
机构
[1] Gen Hosp Peoples Liberat Army, Dept Med Oncol, Beijing 100853, Peoples R China
[2] 401 Hosp Peoples Liberat Army, Dept Med Oncol, Qingdao 266071, Shandong, Peoples R China
[3] Gen Hosp Peoples Liberat Army, Hosp 1, Dept Tradit Chinese Med, Beijing 100048, Peoples R China
[4] Gen Hosp Peoples Liberat Army, Dept Med Oncol, Beijing 100853, Peoples R China
关键词
Human epidermal growth factor receptor 2; Overexpression; Gastric cancer; Liver metastasis; Overall survival; Prognosis; GROWTH-FACTOR RECEPTOR; PROTEIN EXPRESSION; BONE-MARROW; CLINICAL-SIGNIFICANCE; CLINICOPATHOLOGICAL SIGNIFICANCE; GENE AMPLIFICATION; CELL-LINES; C-MET; C-ERBB-2; OVEREXPRESSION;
D O I
10.3748/wjg.v18.i19.2402
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To study the risk factors for liver metastasis and the prognosis in patients with human epidermal growth factor receptor 2 (HER2) over-expressing gastric cancer (GC). METHODS: A total of 84 GC patients recruited from the General Hospital of the People's Liberation Army (PLA) between 2003 and 2010 were randomly enrolled in this study. HERZ expression was detected by immunohistochemistry in 84 GC patients with liver metastases. The study group consisted of 66 men and 18 women, with an average age of 54 years (range: 19-74 years). Liver metastasis was diagnosed by magnetic resonance imaging or computed tomography. Patients were followed-up and predictive factors of liver metastasis were evaluated. RESULTS: The median follow-up period was 47 mo (range: 6-85 mo). The characteristics of 35 (25.7%) patients with HER2 over-expression of liver metastatic GC are presented. HER2 over-expression was detected in 23 out of 49 (46.9%) patients with intestinal GC, and 9 out of 35 (25.7%) patients with diffuse GC. 29 out of 59 (49.2%) patients aged < 60 years were HER-positive, while 8 out of 25 (32%) patients aged 60 were HER2-positive; a significant difference (P < 0.05). Univariate analysis (log-rank test) showed that HER2 over-expression, sex, Lauren classification, differentiation and disease-free interval were correlated with poor survival (P < 0.05). Survival analysis with a survival curve showed that HER2 over-expression was significantly relevant, with a reduced survival time in GC patients with liver metastases (P < 0.01). 2-year survival was not associated with the patient's age. A disease-free survival longer than 12 mo has a significant association with extended overall survival (OS) in GC patients with liver metastases. The median survival time after the diagnosis of liver metastases was 18 mo [95% confidence interval (CI): 9.07-26.94] among HER2 positive GC patients with liver metastases. In comparison, for 49 (69.4%) out of 84 HER2 negative patients with liver metastatic GC, the median survival time was 47 mo (95% CI: 19.37-74.63). In patients with HER2 positive liver metastatic GC, the median OS was significantly shorter than in HER2 negative patients (median, 20.32 mo; 95% CI: 16.51-24.13 vs median, 50.14 mo; 95% CI: 37.83-62.45; P < 0.01). CONCLUSION: HER2 over-expressing GC patients with liver metastases have a poor prognosis. Overall survival was significantly lower in HER2 positive patients. HER2-overexpression is correlated with a lower survival rate. (c) 2012 Baishideng. All rights reserved.
引用
收藏
页码:2402 / 2407
页数:6
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