【摘要】 目的 分析贲门腺癌(GCA)组织中人类表皮生长因子受体-2(Her-2)、Ki-67的表达及其对生存的影响。方法 回顾性分析2012年至2022年郑州大学第一附属医院省部共建食管癌防治国家重点实验室收集的行手术切除的1 661例GCA组织标本，采用免疫组化法检测GCA组织中Her-2和Ki-67的表达情况，分析两者表达与临床病理特征、预后的关系。结果 Her-2表达与患者家族史、Lauren分型、淋巴结转移及分化程度有关。GCA组织中Her-2表达和Ki-67的表达呈负相关(r=-0.070,P=0.004)。Kaplan-Meier生存曲线分析显示，Her-2高表达患者总生存率优于低表达患者(χ~2=17.918,P<0.001),Ki-67低表达患者总生存率优于高表达患者(χ~2=8.530,P=0.004)。COX回归分析显示，年龄、肿瘤大小、Lauren分型、淋巴结转移、浸润程度、Her-2表达及Ki-67表达均是GCA患者预后的独立危险因素。结论 GCA组织中Her-2表达和Ki-67表达呈负相关，Her-2高表达、Ki-67低表达提示患者预后好，联合检测可为GCA患者的治疗及预后评价提供参考。更多还原

【Abstract】 Objective To analyze the expression of human epidermal growth factor receptor-2(Her-2) and Ki-67 in the cancer tissues of patients with gastric cardia adenocarcinoma(GCA), and to explore their associations with survival outcomes. Methods Cancer tissues from 1 661 GCA patients who underwent surgical resection from 2012 to 2022 were retrospectively analyzed by the State Key Laboratory of Esophageal Cancer Prevention and Treatment jointly established by the Provincial and Ministry. Immunohistochemical methods were used to detect the expression of Her-2 and Ki-67 in the GCA tissues, and the relationship between their expression and clinicopathological features and prognosis was analyzed. Results Her-2 expression was associated with family history, Lauren classification, lymph node metastasis and differentiation degree. There was a negative correlation between Her-2 expression and Ki-67 expression in the GCA tissues(r=-0.070,P=0.004). Kaplan-Meier survival curve analysis showed that the overall survival rate of patients with high expression of Her-2 was better than that of patients with low expression(χ~2=17.918,P<0.001); the overall survival rate of patients with low expression of Ki-67 was better than that of patients with high expression(χ~2=8.530,P=0.004). COX regression analysis revealed that age, tumor size, Lauren classification, lymph node metastasis, degree of infiltration, Her-2 expression and Ki-67 expression were the independent prognostic risk factors for GCA. Conclusion High expression of Her-2 suggests a good prognosis, while low expression of Ki-67 suggests a good prognosis, and there is a negative correlation between the expression of Her-2 and Ki-67, their combined assay can provide a reference for the treatment and prognosis evaluation of patients with GCA.更多还原