Comparison Of Two Neoadjuvant Chemotherapies Regimens And Study Of The Correlation The Expression Of Her-2 And Ki-67 With Gastric Cancer

Objectives(1)To compare the efficacy of xelox and Sox neoadjuvant chemotherapies in the treat ment of gastric cancer in order to explore a therapy with better clinical outcomes for patients. (2) To study the correlations the expression status of Her-2 and Ki-67 proteins in patients with gastric carncer in Hexi Area.Methods:(1)A total of 86 random gastric cacinoma cases in the Department of Oncological Surg ery in First Hospital of Lanzhou University from September 2012 to March 2014 are divided into t hexeloxgroup(40cases)andtheSoxgroup(46cases). After treated with 3 periods of neoadjuvant che motherapies, the xelox and Sox groups are observed and compared in terms of recent efficacy, turn or stages.(2) 83 have received gastrectomy,and their surgical specimens are all examined Her-2 and Ki-67 proteins by immunohistochemistry(IHC) method. These cases are then divided into the positive group and the negative group based on their IHC results and the statistic is then analyzed in each clinical observation category.Results:(1)Among the 40 cases receiving xelox neoadjuvant chemotherapy, there are 2cases(5.0 %)ofCR,10cases(25.0%)ofPR,12 cases(30.0%) of SD,16cases(40.0%)ofPD,12cases(30.0%)ofRR, and24cases(60.0%)ofDCR.5 cases (12.5%) are in postoperative phase,3 cases (7.5%) in phase,12 c ases (30.0%) in phase Ⅲ, and 20 cases (50.0%) in phase Ⅳ.(2)Among the 46 cases receiving sox neoadjuvant chemotherapy, there are 4 cases(9,0%) of CR,23 cases(50.0%)ofPR,12cases(26.0%)ofSD,7cases(15.0%)ofPD,27 cases (59.0%) of RR,and39cases (85.0%) ofDCR.17 cases (37%) are in postoperative phase,11 cases (24%) in phase Ⅱ,5 cases (11. 0%) in phase Ⅲ, and 13 cases (28.0%) in phase Ⅳ.To the PR, sox neoadjuvant chemotherapy is more than xelox neoadjuvant chemotherapy(x2=5.655,.P=0.017). To the PD, xelox neoadjuvant chemotherapy is more than sox neoadjuvant chemotherapy(χ2=6.707, P=0.010). The cases of sox neoadjuvant chemotherapy is more than xelox neoadjuvant chemotherapy in Phase Ⅰ、Ⅱ cases(χ2=6.722,P=0.010、χ2=4.229,P=0-040).Thecasesofxelox neoadjuvant chemo therapy is more than sox neoadjuvant chemotherapy in PhaseⅢ、Ⅳcases(χ2=4.937,P =0.026、χ2=4.276,P=0.039).(3) IHC is applied to detect the expression status of Her-2 protein.43 cases show positive expression (++or+++). The rate of Her-2 protein expression is therefore 52%.And the other 40 cases (48%) show negative expression (0 or+). The expression status of Her-2 protein is not significantly correlated with the age (χ2=0.490, P=0.484)and gender (χ2=0.194, P=0.660)of gastric carcinoma patients. The positive rate of Her-2 protein expression is higher than the negative rate in well-differentiated adenocarcinoma(χ2=4.574, P=0.032). The negative rate of Her-2 protein expression is higher than the positive rate in the poorly-differentiated adenocarcinoma(χ2=4.270, P =0.039). The negative rate of Her-2 protein expression is higher than the positive rate in Phase I cases(χ2=11.521, P=0.001). The positive rate of Her-2 protein expression is higher than the negative rate in Phase III cases(χ2=5.662, P=0.018). The positive rate of Her-2 protein expression is higher than the negative rate when tumors are developed at the cardia of stomach(χ2=4.335, P =0.037). The negative rate of Her-2 protein expression is higher than the positive rate when the tumors are developed at the lesser curvature of the stomach(χ2=7.314, P=0.007).(4) IHC is applied to detect the expression status of Ki-67 protein.37 cases show positive expression. The rate of Ki-67 protein expression is therefore 45%.And the other 46 cases (55%) show negative expression. The expression status of Ki-67 protein is not significantly correlated with the age(χ2=1.383, P=0.240) and gender (χ2=0.937, P=0.333)of gastric carcinoma patients. The positive rate of Ki-67 protein expression is higher than the negative rate in poorly-differentiated adenocarcinoma(χ2=5.706, P=0.017). The negative rate of Ki-67protein expression is higher than the positive rate in Phase I case(χ2=5.486, P=0.019)s. The positive rate of Ki-67 protein expression is higher than the negative rate in PhaseⅢ cases(χ2=7.263, P=0.007). The positive rate of Ki-67 protein expression is higher than the negative rate when the tumors are developed at the cardia of the stomach(x~2=4.908.p=0.027).)Conclusions:(1).Sox neoadjuvant chemotherapy in the treatment of gastric cancer is significantly better than xelox in tenns of short-term effect.(2). The high expression rate of Her-2 protein in well-differentiated adenocarcinoma,the low expression rate of Her-2 protein in poorly-differentiated adenocarcinoma in gastric cancer.(3). The high expression rate of Her-2 protein in Phase III,the low expression rate of Her-2protein in Phase I in gastric cancer.(4). The high expression rate of Her-2 protein at cardia, the low expression rate of Her-2 protein at the lesser curvature of stomach in gastric cancer.(5). The high expression rate of Ki-67 protein in poorly-differentiated adenocarcinoma in gastric cancer.(6). The high expression rate of Ki-67 protein in Phase III gastric cancer, the low expression rate of Ki-67 protein in Phase I in gastric cancer.(7). The high expression rate of Ki-67 protein when tumors are developed at the cardia.