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目的探讨胃癌中人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)和血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达与胃癌的发生、发展的关系,及作为分子靶点指导胃癌患者临床用药的意义。方法采用免疫组化(immunohistochemistry,IHC)的方法检测103例胃癌患者HER2及VEGF的状态,同时联合荧光原位杂交的方法检测HER2的状态,并与患者的临床资料进行相关性分析。结果①胃癌中HER2扩增率约为11%(11/103),在阳性病例中IHC与荧光原位杂交(fluorescentin situ hydridization,FISH)方法的符合率为90%,具有相关性(P<0.01);②HER2的扩增与胃癌的病理分级、淋巴结转移与否及Lauren分型相关(P<0.05);③胃癌中VEGF表达阳性率约为24%(25/103),VEGF的阳性表达与肿瘤的浸润深度、病理分级、Lauren分型相关(P<0.05);④HER2的表达与VEGF的表达不相关(P>0.05)。结论 HER2、VEGF的阳性表达与胃癌特别是分化较好的胃管状腺癌的发生、发展密切相关。联合检测HER2及VEGF在胃癌(特别是肠型胃癌)中的表达对了解胃癌的发生、发展,及靶向药物曲妥珠单抗和贝伐单抗的选择具有重要意义。
Objective To investigate the relationship between the expression of human epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor (VEGF) and the occurrence and development of gastric cancer in gastric cancer and their molecular targets To guide the clinical significance of gastric cancer patients. Methods Immunohistochemistry (IHC) was used to detect the expression of HER2 and VEGF in 103 patients with gastric cancer. The status of HER2 was detected by fluorescence in situ hybridization and correlated with the clinical data of patients. Results ① The rate of HER2 amplification in gastric cancer was about 11% (11/103). The coincidence rate of IHC and FISH in positive cases was 90% (P <0.01) ); ② The amplification of HER2 was correlated with the pathological grading of gastric cancer, lymph node metastasis and Lauren classification (P <0.05); ③The positive rate of VEGF expression in gastric cancer was about 24% (25/103) (P <0.05). ④The expression of HER2 was not correlated with the expression of VEGF (P> 0.05). Conclusion The positive expression of HER2 and VEGF is closely related to the occurrence and development of gastric carcinoma, especially the well-differentiated gastric tubular adenocarcinoma. Combined detection of HER2 and VEGF expression in gastric cancer (especially intestinal type gastric cancer) is of great significance to understand the occurrence and development of gastric cancer and the choice of targeted trastuzumab and bevacizumab.