| 潘婷婷,赵 达,唐君霞.Ki-67、ERCC1的表达对胃癌新辅助化疗病理学缓解的预测价值[J].中国肿瘤,2019,28(7):543-548. |
| Ki-67、ERCC1的表达对胃癌新辅助化疗病理学缓解的预测价值 |
| ERCC1 and Ki-67 Expression Level in Predicting Pathological Response Following Neoadjuvant Chemotherapy in Gastric Cancer Patients |
| 投稿时间：2019-01-07 |
| DOI：10.11735/j.issn.1004-0242.2019.07.A012 |
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| 中文关键词: 胃癌 新辅助化疗 ki-67 ERCC1 病理完全缓解 |
| 英文关键词:gastric cancer neoadjuvant chemotherapy ki-67 ERCC1 pathological complete response |
| 基金项目:国家重点研发计划(2017YFC0908300) |
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| 中文摘要: |
| 摘 要：［目的］ 探讨胃癌患者组织中ERCC1、ki-67表达及变化与新辅助化疗（neoadjuvant chemotherapy，NAC）敏感性的关系。［方法］ 收集126例NAC后行R0切除术的胃癌患者，通过免疫组织化学方法检测患者第1次胃镜取检及术后标本癌组织中ki-67、ERCC1的表达水平，结合相关临床病理因素，采用χ2检验、多因素Logistic回归及Spearman相关分析法分析数据。［结果］ 单因素分析显示：T分期、临床分期、ki-67表达、NAC前后ki-67变化及ERCC1表达均与NAC疗效相关（均P＜0.05）；T分期、ki-67的表达及ERCC1的表达与胃癌患者NAC后病理完全缓解（pathological complete response，pCR）相关（P＜0.05）；多因素Logistic回归结果显示ki-67表达(OR=7.956，95%CI：1.305～48.492，P=0.025）、NAC前后ki-67变化(OR=6.497，95%CI：1.125～37.528，P=0.036)及ERCC1表达(OR=5.271，95%CI：1.020～27.255，P=0.047)均为NAC疗效的独立影响因素；ki-67(OR=0.260，95%CI：0.080～0.849，P=0.026）及ERCC1(OR=0.264，95%CI：0.078～0.899，P=0.033）的表达为pCR的独立影响因素；且ki-67的表达与ERCC1的表达无相关性（P＞0.05）。［结论］ Ki-67、ERCC1的表达是胃癌患者NAC疗效的独立预测因子，同时结合其他相关指标，将更有利于指导个体化NAC。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the expression level of Ki-67 and ERCC1 in patients with gastric cancer undergoing neoadjuvant chemotherapy(NAC) . ［Methods］ One hundred and twenty-six patients with gastric cancer who underwent radical surgery after NAC were enrolled. The expression level of ki67 and ERCC1 in tumor tissues from the gastroscopy and postoperative specimens were detected with immunohistochemistry. The predictive value of Ki67 and ERCC1 expression for NAC response was analyzed by multivariate Logistic regression and Spearman correlation methods. ［Results］ The univariate analysis showed that response rate after NAC was significantly related to the T stage，clinical stage，ki-67 expression and ki-67 changes after NAC as well as ERCC1 expression(P<0.05)；T staging，ki-67 expression and ERCC1 expression were correlated with pathological complete response(pCR) after NAC in gastric cancer patients(P<0.05). Multivariate analysis revealed that Ki-67(OR=7.956，95%CI：1.305～48.492，P=0.025），ki-67 changes after NAC(OR=6.497，95%CI：1.125～37.528，P=0.036) and ERCC1(OR=5.271，95%CI：1.020～27.255，P=0.047) expression level were the independent predictive factors for response rate of NAC；the expressions of ki-67(OR=0.260，95%CI：0.080～0.849，P=0.026) and ERCC1(OR=0.264，95%CI：0.078～0.899，P=0.033) were independent factors affecting pCR. There was no correlation between ki-67 expression and ERCC1 expression(P>0.05). ［Conclusion］In gastric cancer patients，high Ki-67 expression and negative ERCC1 expression are predictive indicators for high pathological response rate after NAC. Meanwhile，it may be helpful for better individualized NAC planning with combined considerations of the status of other related factors. |
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