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Serum HER2 as a predictive biomarker for tissue HER2 status and prognosis in patients with gastric cancer

World Journal of Gastroenterology 2017年第10期23卷 1836-1842页

作者： Hong-Zhi Shi Yu-Ning Wang Xiao-Hui Huang Ke-Cheng Zhang Hong-Qing Xi Jian-Xin Cui Guo-Xiao Liu Wen-Tao Liang Bo Wei Lin Chen Department of General Surgery Chinese PLA General Hospital Department of General Surgery General Hospital of Armed Police Force Department of Surgery Chinese PLA General Hospital Institute of General Surgery Chinese PLA General Hospital

AIM To investigate the association between serum human epidermal growth factor receptor 2(HER2) extracellular domain(ECD) and tissue HER2 status, and the prognostic value of serum HER2 ECD in patients with gastric *** A total of 239 patients with gastric cancer were enrolled from December 2012 to June 2013. Serum HER2 ECD was determined by chemiluminescent assay, and tissue HER2 status was evaluated by immunohistochemistry and fluorescence in situ hybridization assay. A receiver operating characteristic(ROC) curve was plotted to identify the optimal cut-off value for serum HER2 ECD assay for predicting survival in gastric cancer *** Serum HER2 ECD was significantly correlated with tissue HER2 status(P < 0.001), tumor size(P < 0.001), and intestinal type of gastric cancer(P =0.021). Serum HER2 ECD levels differed significantly between patients with HER2-positive tissue expression and those with HER2-negative tissue expression. ROC analysis yielded an area under the curve value of 0.79(95%CI: 0.71-0.87, P < 0.001), with a sensitivity and specificity of 0.54(95%CI: 0.37-0.70) and 0.93(95%CI: 0.88-0.96), respectively. With a cut-off value of 24.75 ng/m L, high serum HER2 ECD had a negative impact on overall survival of the patients(HR: 1.93, 95%CI: 1.32-4.38, P = 0.006). CONCLUSION Serum HER2 ECD could be a highly specific surrogate biomarker for tissue HER2 status in gastric cancer. Optimal cut-off criteria for predicting survival should be established.

关键词： Gastric cancer Serum HER2 extracellular domain Tissue HER2 status Prognosis

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Timing of surgery after neoadjuvant chemotherapy for gastric cancer: Impact on outcomes

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World Journal of Gastroenterology 2018年第2期24卷 257-265页

作者： Yi Liu Ke-cheng Zhang Xiao-hui huang hong-qing Xi Yun-he Gao Wen-quan Liang Xin-Xin Wang Lin chen Department of General Surgery & Institute of General Surgery Chinese People's Liberation Army General Hospital

AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm *** One hundred and seventy-six patients with gastric cancer undergoing NAc T and a planned gastrectomy at the chinese p LA General hospital were selected from January 2011 to January 2017. Univariate and multivariable analyses were used to investigate the impact of NAc T-surgery interval time( 6 wk) on pc R rate and overall survival(OS).RESULTS The NAc T-surgery interval time and clinician T stage were independent predictors of pc R. The interval time > 6 wk was associated with a 74% higher odds of pc R as compared with an interval time of 4-6 wk(p = 0.044), while the odds ratio(OR) of clinical T3 vs clinical T4 stage for pc R was 2.90(95%c I: 1.04-8.01, p = 0.041). In cox regression analysis of long-term survival, postneoadjuvant therapy pathological N(yp N) stage significantly impacted OS(N0 vs N3: h R = 0.16, 95%c I: 0.37-0.70, p = 0.015; N1 vs N3: h R = 0.14, 95%c I: 0.02-0.81, p = 0.029) and disease-free survival(DFS)(N0 vs N3: h R = 0.11, 95%c I: 0.24-0.52, p = 0.005; N1 vs N3: h R = 0.17, 95%c I: 0.02-0.71, p = 0.020). The surgical procedure also had a positive impact on OS and DFS. The hazard ratio of distal gastrectomy vs total gastrectomy was 0.12(95%c I: 0.33-0.42, p = 0.001) for OS, and 0.13(95%c I: 0.36-0.44, p = 0.001) for *** The NAc T-surgery interval time is associated with pc R but has no impact on survival, and an interval time > 6 wk has a relatively high odds of pc R.

关键词： Gastric cancer Timing of surgery Neoadjuvant chemotherapy

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Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer

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World Journal of Gastroenterology 2019年第38期25卷 5838-5849页

作者： Wen-Quan Liang Ke-Cheng Zhang Jian-Xin Cui Hong-Qing Xi Ai-Zhen Cai Ji-Yang Li Yu-Hua Liu Jie Liu Wang Zhang Peng-Peng Wang Bo Wei Lin Chen Department of General Surgery&Institute of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100853China Institute of Army Hospital Management Chinese People’s Liberation Army General HospitalBeijing 100853China Department of Vascular and Endovascular Surgery Chinese People’s Liberation Army General HospitalBeijing 100853China

BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent *** on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of *** hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer *** To investigate the risk factors for PPOI and establish a nomogram for clinical risk *** Between June 2016 and March 2017,the data of 162 patients with gastrectomy were obtained from a prospective and observational registry *** data of patients who fulfilled the criteria were *** and multivariable logistic regression models were performed to detect the relationship between variables and PPOI.A nomogram for PPOI was developed and verified by bootstrap *** calibration curve was employed to detect the concentricity between the model probability curve and ideal *** clinical usefulness of our model was evaluated using the net benefit *** This study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent *** incidence of PPOI was 19.75%in patients with *** older than 60 years,open surgery,advanced stage(III–IV),and postoperative use of opioid analgesic were independent risk factors for *** developed a simple and easy-to-use prediction nomogram of PPOI after *** nomogram had an excellent diagnostic performance[area under the curve(AUC)=0.836,sensitivity=84.4%,and specificity=75.4%].This nomogram was further validated by bootstrapping for 500 *** AUC of the bootstrap model was 0.832(95%CI:0.741–0.924).This model showed a good fitting and calibration and positive net benefits in decision curve *** We have developed a prediction nomogram of PPOI for gastric *** novel nomogram might serve as an essential early war

关键词： Prolonged postoperative ileus Gastric cancer Complication Nomogram Bootstrap

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