Expression Of HER-2 In Gastric Carcinoma And Its Correlation With Prognosis

Background: Gastric cancer is one of the main killer of human health,its development and progression involve the changes of many factors,which is an evolved complex process about multi-level and steps and stages,including gene locus mutation,the change of alleles and etc.It has been proved that the over-expression and gene amplification of human epidermal growth factor receptor 2(HER-2)have a big influence on a variety of tumor,such as their invasion,metastasis and prognosis.In recent years,the study of the correlation between HER-2 and the development and progression of gastric cancer has become a hotspot,however,domestic and international scholars still have controversy about the correlation on HER-2 over-expression and gastric cancer,and do not classify the HER-2 positive gastric carcinoma and research it by big date,and also do not regard HER-2 detection as a routine examination in gastric cancerpatients.Objective: This study has examined the relationship between HER-2 over-expression and the biological behavior and pathological characteristics of gastric cancer,retrospectively contrasted and analysised its influence on survival time,analyzed if HER-2 can be regard as an independent factor that affect the prognosis of gastric cancer,and provide clinical basis for individualized precise target therapy for gastric cancer patients,and be better used to predict the prognosis of gastric cancer patients.Methods:Collecting 84 cases specimen of gastric carcinoma patients from Nanyang Central Hospital from2012.01.01to2014.12.30,which have been proved to be gastric carcinoma by postoperative pathological and have complete clinical information.Using immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)to detect the expression of HER-2 in pathological tissue samples,and definitude the relationship between HER-2 expression and the clinical pathological features of gastric cancer,and the influence of HER-2 over-expression on survival time and prognosis.Using SPSS21.0 statistical software to analyze the data.Results:1.HER-2 positive expression rate is about 11.9%(10/84)in 84 cases of gastric cancer tissues;2.HER-2 positive expression rate in male and female patients are 13.33% and 8.33% respectively,and in age ?60 years old and>60 years old patients,the positive expression rate are 10.53% and 13.04% respectively;in 25 cases of high and medium differentiation samples,HER-2 positive expression rate is 8.00%(2/25),and in low differentiated group the positive expression rate is 13.56%(8/59);the positive expression rate of HER-2 in longest diameter ?5cm and>5cm was 10.87%(5/46)and 13.16%(5/38)respectively,about above index,the study showed no statistical significance(P>0.05);3.In 24 patients of T1 and T2 stages,there has no HER-2 positive cases been found,in 60 patients of T3 and T4 stages,the positive expression rate was 16.67%(10/60);the positive expression rate was 18.00%(9/50)and 2.94%(1/34)in lymph node metastasis positive and negative group;the positive expression rate in intestinal type is significantly higher than in diffuse gastric cancer(21.88% vs 5.77%);In phase ? patients,there is no positive expression case,in phase ? patients,we found one case with HER-2 over-expression,the over-expression rate in phase ? and ? is 3.03%(1/33),and in ? period is 17.65%(9/51),The above differences have statistical significance(P<0.05);4.The result of univariate survival analysis by using log-rank showed that the gastric cancer patients who has HER-2 over-expression or gene amplification have a shorter median survival time than HER-2 negative patients(P<0.05);5.The expression of HER-2 can be used as an independent parameters for prognosis of gastric cancer by analysis of Cox proportional hazards regression model.Conclusion:1.HER-2 over-expression or gene amplification exist in gastric cancer;2.In gastric cancer tissues,there are no significant correlation between the expression of HER-2 and patients' gender,age,degree of differentiation and tumor size(P>0.05),but significantly related to tumor infiltration depth,and lymph node metastasis,and tumor TNM stage and Lauren classification(P<0.05);3.The gastric cancer patients who has HER-2 over-expression or gene amplification have a poor prognosis and no survival advantage,and its survival time significantly shorter than HER-2 negative patients;4.HER-2 can be used as an independent factor that affect the prognosis of gastric cancer.