进展期胃癌多层螺旋CT表现与HER2表达的相关性
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摘要
目的探讨进展期胃癌多层螺旋CT不同影像表现与人类表皮生长因子受体-2(HER2)基因表达之间的关系。资料与方法回顾性分析2015年1月—2017年6月于锦州医科大学附属第一医院行多层螺旋CT检查,并进行胃癌根治术的患者169例。检测患者原发肿瘤影像征象(最大径线、最大厚度、静脉期强化差值、浆膜面受侵)与转移征象(淋巴结转移、远处转移)以及HER2基因表达情况。使用组内相关系数(ICC)检查2名观察者间定量测量的一致性;比较HER2阳性与阴性表达的差异,并将存在统计学意义相关因素纳入Logistic回归方程分析。结果 2名观察者对所有定量特征的测量一致性较高(ICC>0.75)。HER2阳性组出现浆膜面受侵犯和淋巴结转移分别为54例和44例;HER2阴性组浆膜面受侵犯、淋巴结转移分别为47例和28例,两组间浆膜受侵犯率(x~2=7.320)、淋巴结转移率(x~2=9.322)差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示浆膜面受侵(OR=2.013)、淋巴结转移(OR=2.068)是HER2表达的独立预测因素(P<0.05)。结论多层螺旋CT检查中浆膜面受侵、淋巴结转移等CT征象可初步估计进展期胃癌HER2的表达状态,从而为临床治疗提供参考。
Purpose To explore the relationship between varied imaging findings of multi-slice spiral CT and gene expression of human epidermal growth factor receptor 2(HER2) regarding advanced gastric cancer. Materials and Methods A retrospective analysis of 169 patients who underwent multi-slice spiral CT examination and received radical gastrectomy at the First Affiliated Hospital of Jinzhou Medical University from January 2015 to June 2017 was performed. The patients' primary tumor imaging signs(maximum diameter, maximum thickness, venous phase enhancement difference value, and serosal surface invasion), metastatic signs(lymph node metastasis, distant metastasis) and HER2 gene expression were examined. The consistency of quantitative measurements between the two observers was checked using interclass correlation coefficient(ICC). The difference between HER2 positive expression and negative expression was compared, and relevant factors with statistical significance were included in logistic regression equation for analysis.Results There was relatively high measurement consistency of all quantitative features between the two physicians(ICC>0.75). In the HER2 positive group, 54 cases and 44 cases respectively showed serosal invasion and lymph node metastasis; while in the HER2 negative group, the figure was about 47 cases and 28 cases, respectively, suggesting that the difference concerning the rate of serosal invasion(x~2=7.320) and lymph node metastasis(x~2=9.322) between the two groups was statistically significant(P<0.05). The results of multivariate logistic regression analysis indicated that serosal invasion(OR=2.013) and lymph node metastasis(OR=2.068) were independent predictors of HER2 expression(P<0.05). Conclusion CT findings such as serosal invasion and lymph node metastasis in multi-slice spiral CT can be used for preliminary estimate of expression status of advanced gastric cancer HER2, thus providing a reference for clinical treatment.
Purpose To explore the relationship between varied imaging findings of multi-slice spiral CT and gene expression of human epidermal growth factor receptor 2(HER2) regarding advanced gastric cancer. Materials and Methods A retrospective analysis of 169 patients who underwent multi-slice spiral CT examination and received radical gastrectomy at the First Affiliated Hospital of Jinzhou Medical University from January 2015 to June 2017 was performed. The patients' primary tumor imaging signs(maximum diameter, maximum thickness, venous phase enhancement difference value, and serosal surface invasion), metastatic signs(lymph node metastasis, distant metastasis) and HER2 gene expression were examined. The consistency of quantitative measurements between the two observers was checked using interclass correlation coefficient(ICC). The difference between HER2 positive expression and negative expression was compared, and relevant factors with statistical significance were included in logistic regression equation for analysis.Results There was relatively high measurement consistency of all quantitative features between the two physicians(ICC>0.75). In the HER2 positive group, 54 cases and 44 cases respectively showed serosal invasion and lymph node metastasis; while in the HER2 negative group, the figure was about 47 cases and 28 cases, respectively, suggesting that the difference concerning the rate of serosal invasion(x~2=7.320) and lymph node metastasis(x~2=9.322) between the two groups was statistically significant(P<0.05). The results of multivariate logistic regression analysis indicated that serosal invasion(OR=2.013) and lymph node metastasis(OR=2.068) were independent predictors of HER2 expression(P<0.05). Conclusion CT findings such as serosal invasion and lymph node metastasis in multi-slice spiral CT can be used for preliminary estimate of expression status of advanced gastric cancer HER2, thus providing a reference for clinical treatment.
引文
[1]Siegel R,Ma JM,Zou ZH,et al.Cancer statistics,2014.CACancer J Clin,2014,64(1):9-29.
[2]Bang YJ,Van Cutsem E,Feyereislova A,et al.Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer(ToGA):a phase 3,openlabel,randomised controlled trial.Lancet,2010,376(9742):687-697.
[3]Park JS,Rha SY,Chung HC,et al.Clinicopathological features and prognostic significance of HER2 expression in gastric cancer.Oncology,2015,88(3):147-156.
[4]Liu S,Liu S,Ji C,et al.Application of CT texture analysis in predicting histopathological characteristics of gastric cancers.Eur Radiol,2017,27(12):4951-4959.
[5]Habermann CR,Weiss F,Riecken R,et al.Preoperative staging of gastric adenocarcinoma:comparison of helical CTand endoscopic US.Radiology,2004,230:465-471.
[6]Amin MB,Edge SB,Greene FL,et al,AJCC Cancer Staging Manual.8th ed.New York:Springer,2017:208-209.
[7]《胃癌HER2检测指南》编写组.胃癌HER2检测指南.中华病理学杂志,2011,40(8):553-557.
[8]Nagaraja V,Eslick GD.HER2 expression in gastric and oesophageal cancer:a meta-analytic review.J Gastrointest Oncol,2015,6(2):143-154.
[9]J?rgensen JT,Hersom M.HER2 as a prognostic marker in gastric cancer-a systematic analysis of data from the literature.J Cancer,2012,3:137-144.
[10]Aggarwal A,Liu ML,Krasnow SH.Breast cancer in male veteran population:an analysis from VA cancer registry.JCommunity Support Oncol,2014,12(8):293-297.
[11]唐磊.胃癌影像学分期与评效--多学科诊疗的需求与对策.中华胃肠外科杂志,2015,18(3):208-212.
[12]Wang XL,Chen XM,Fang JP,et al.Overexpression of both VEGF-A and VEGF-C in gastric cancer correlates with prognosis,and silencing of both is effective to inhibit cancer growth.Int J Clin Exp Pathol,2013,6(4):586-597.
[13]Lee JS,Kim SH,Im SA,et al.Human epidermal growth factor receptor 2 expression in unresectable gastric cancers:relationship with CT characteristics.Korean J Radiol,2017,18(5):809-820.
[14]Aizawa M,Nagatsuma AK,Kitada K,et al.Evaluation of HER2-based biology in 1,006 cases of gastric cancer in a Japanese population.Gastric Cancer,2014,17(1):34-42.
[15]He C,Bian XY,Ni XZ,et al.Correlation of human epidermal growth factor receptor 2 expression with clinicopathological characteristics and prognosis in gastric cancer.World JGastroenterol,2013,19(14):2171-2178.
[2]Bang YJ,Van Cutsem E,Feyereislova A,et al.Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer(ToGA):a phase 3,openlabel,randomised controlled trial.Lancet,2010,376(9742):687-697.
[3]Park JS,Rha SY,Chung HC,et al.Clinicopathological features and prognostic significance of HER2 expression in gastric cancer.Oncology,2015,88(3):147-156.
[4]Liu S,Liu S,Ji C,et al.Application of CT texture analysis in predicting histopathological characteristics of gastric cancers.Eur Radiol,2017,27(12):4951-4959.
[5]Habermann CR,Weiss F,Riecken R,et al.Preoperative staging of gastric adenocarcinoma:comparison of helical CTand endoscopic US.Radiology,2004,230:465-471.
[6]Amin MB,Edge SB,Greene FL,et al,AJCC Cancer Staging Manual.8th ed.New York:Springer,2017:208-209.
[7]《胃癌HER2检测指南》编写组.胃癌HER2检测指南.中华病理学杂志,2011,40(8):553-557.
[8]Nagaraja V,Eslick GD.HER2 expression in gastric and oesophageal cancer:a meta-analytic review.J Gastrointest Oncol,2015,6(2):143-154.
[9]J?rgensen JT,Hersom M.HER2 as a prognostic marker in gastric cancer-a systematic analysis of data from the literature.J Cancer,2012,3:137-144.
[10]Aggarwal A,Liu ML,Krasnow SH.Breast cancer in male veteran population:an analysis from VA cancer registry.JCommunity Support Oncol,2014,12(8):293-297.
[11]唐磊.胃癌影像学分期与评效--多学科诊疗的需求与对策.中华胃肠外科杂志,2015,18(3):208-212.
[12]Wang XL,Chen XM,Fang JP,et al.Overexpression of both VEGF-A and VEGF-C in gastric cancer correlates with prognosis,and silencing of both is effective to inhibit cancer growth.Int J Clin Exp Pathol,2013,6(4):586-597.
[13]Lee JS,Kim SH,Im SA,et al.Human epidermal growth factor receptor 2 expression in unresectable gastric cancers:relationship with CT characteristics.Korean J Radiol,2017,18(5):809-820.
[14]Aizawa M,Nagatsuma AK,Kitada K,et al.Evaluation of HER2-based biology in 1,006 cases of gastric cancer in a Japanese population.Gastric Cancer,2014,17(1):34-42.
[15]He C,Bian XY,Ni XZ,et al.Correlation of human epidermal growth factor receptor 2 expression with clinicopathological characteristics and prognosis in gastric cancer.World JGastroenterol,2013,19(14):2171-2178.