摘要
目的 研究显示,人类表皮生长因子受体-2（human epidermal growth factor receptor-2,HER-2）的表达状态和抗HER-2治疗的发展改善了胃癌患者的预后。但是,HER-2在可切除胃癌患者的预后价值方面仍有争议。本研究探讨HER-2表达与可切除胃癌患者临床病理相关因素及总生存的相关性。方法 采用Cochrane系统评价方法,通过检索Cochrane library、PubMed、Embase、Sciencedirect和Springer等数据库,在2015-05前公开发表的HER-2表达和可切除胃癌预后关系的临床试验文献。应用RevMan 5.3软件进行Meta分析。采用Newcastle-Ottawa Scale（NOS）量表对入选文献进行质量评价。结果 7篇文献共1 805例患者纳入研究,入选文献质量评分均〉6分。结果显示,HER-2表达在肠型与弥漫型及其他中的差异有统计学意义,OR=4.33,95%CI为3.14~5.98,P〈0.001;HER-2表达在男性与女性组差异有统计学意义,OR=2.61,95%CI为1.74~3.91,P〈0.001;HER-2在高/中分化组与低分化/其他组的表达差异有统计学意义,OR=4.61,95%CI为3.2~6.65,P〈0.001。HER-2表达与淋巴结转移（OR=0.79,95%CI为0.56~1.12,P=0.19）、肿瘤浸润深度（OR=1.05,95%CI为0.71~1.54,P=0.82）、临床TNM分期（OR=0.83,95%CI为0.57~1.21,P=0.34）和胃癌周围淋巴管侵袭（OR=1.13,95%CI为0.64~1.98,P=0.68）均无关;HER-2阳性表达组与患者总生存期有显著相关性,HR=0.47,95%CI为0.38~0.58,P〈0.001。结论 HER-2阳性表达在肠型胃癌,男性患者,高/中分化组更常见,HER-2阳性表达与胃癌患者总生存期有显著相关性。
OBJECTIVE Identification of the importante of human epidermal grovoth factor receptor-2 （HER-2） treatments has changed the prognosis of gastric cancers, while the prognostic value of HER-2 in resectable gastric cancer is controversial. This stud was designed to investigate clinicopathological and prognostic significance of HER-2 overexpres- sion in resectable gastric cancer. METHODS The literature databases, such as Cochrane library, PuhMed, Embase, sci- encedirect, springer were extensively searched to retrieve the clinical studies of HER-2 expression in resectable gastric cancer published before May, 2015. Statistical analysis was carried out by Revman software 5.3. The Newcastle-Ottawa scale was used to assess the quality of evidence. RESULTS Seven case-control trails involving a total of 1805 patients were studied. The results suggested that HER-2 overexpression was associated with intestinal type （OR= 4.33, 95 %CI： 3.14-5.98 ,P〈0. 001） ,male gender （OR=2.61, 95%CI： 1.74-3.91 ,P〈0. 001） ,well and moderate cell differentiation （OR=4.61, 95%CI：3.2-6. 65,P〈0.001）. It had no correlation with lymph node metastasis（P=0. 79）, depth of tumor （P= 0.82）, clinical stages（P= 0.34）, lymphovascular invasion（P= 0.68）. There was significant difference in over- all survival between positive HER-2 and negative HER-2 patients （HR=0.47, 95%CI：0.38-0.58,P〈0. 001）. CON- CLUSION HER-2-positive expression is associated with intestinal type, male gender, well and moderate cell differentiation, HER-2 positive expression is a prognostic factor for gastric carcinoma.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第23期1843-1847,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
胃肿瘤
人表皮生长因子受体2
预后
META分析
stomach neoplasm
human epidermal growth factor receptor 2
prognostic
Meta-analysis
