| [Objective] To evaluate the clinical efficacy and toxicity of two regimens of DCF (or DF) or FOLFOX as adjuvant chemotherapy in patients with curatively resected gastric carcinoma; To explore the expressions of P53,EGFR,HER-2,VEGF,PTPRO in gastric carcinoma and to explore potential molecular predictors of therapeutic effect and recurrence risk.Method Patients in Chinese PLA General Hospital from January 2004 to December 2007 with stageâ…¡or III gastric carcinoma who underwent gastrectomy with extended (D2) lymph-node dissection were retrospectively reviewed. Adjuvant chemotherapy with DCF (or DF) or with FOLFOX regimen followed. DCF (or DF) group:44 cases, FOLFOX:90 cases.To evaluate the clinical efficacy and toxicity of them.And IHC results of P53,EGFR,HER-2,VEGF were analyzed. The PTPRO expression profile was detected by IHC in tissues of sixty-one cases primary tumor,paired surrouding normal tissue,metastatic lymph node. Then the correlation between their expressions, clinicopathologic characteristics and survival was analyzed by PASWStatistics18.0 software.Result In 134 assessable patients,the median follow-up was 32 months. Untill March 11th 2010, there were 61 (45.5%) cases dead.1. MDFS of DCF (or DF) and FOLFOX group was 27.43months respectively(P>0.05), Subgroup analysis showed that the effect of chemotherapy was not influenced by clinical stage.MST of them was 52,59months respectively; three-year overall survival rate was 44.2%,68.5% respectively (P>0.05).The incidence rate of leukocytopenia of the former was higher than the latter's;the incidence rate of peripheral neuritis of the former was lower than the latter's (P>0.05).2.The positive expression rates of P53,EGFR,HER-2,VEGF were 39.8%,18.5%,18.5% and 51.5% respectively. EGFR expression correlated with p53's positively (r=0.233,P<0.05);VEGF expession correlated with HER-2's negatively (r=-0.242,P<0.05).The expressions of EGFR,HER-2,VEGF didn't correlate with age et al clinicopathologic characteristics (P>0.05).P53 expression only correlated with histological grade,stage(P<0.05).MDFS of the negative,positive expression of P53 was 50,20months respectively(P<0.05), MST was 66,28 months respectively(P<0.05). Subgroup analysis showed that MDFS,MST were longer with FOLFOX(40,36months) versus DCF(10.22 months) in p53 positive patients (p<0.05).3. In 61 patients, the positive rates of PTPRO in primary tumor,paired surrouding normal tissue and metastatic lymph node were 65.6%,94.8% and 65.9% respectively, with a significant difference among the three groups(P<0.01). The positive rate of p53 was 36.5%. There was no significant association between PTPRO and P53 protein expressions(r=0.169, P=0.20). The expression of PTPRO didn't correlate with age et al clinicopathologic characteristics(P>0.05). Cox regression analysis showed that PTPRO,P53 protein expressions and clinical stage were independent prognostic factors of DFS. PTPRO,P53 protein expressions,differentiation and clinical stage were independent prognostic factors of OS.Conclusions: 1.DCF(or DF) and FOLFOX regimens are effective adjuvant treatments with tolerable toxicity for Chinese patients with resected gastric carcinoma.2.There was no significant association between the expressions of EGFR,HER2,VEGF and survival.Adjuvant chemotherapy can improve P53 negative patients'DFS,OS. FOLFOX regimen is better suitable for the P53 positive patients than DCF regimen.3.PTPRO expression was significantly reduced in the gastric carcinoma and involved in carcinogenesis,development of gastric carcinoma. PTPRO,P53 protein expressions are potential predictive biomarkers for gastric carcinoma patients who received adjuvant chemotherapy after D2 radical correction.
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