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目的:探讨晚期胃癌患者中胰岛素样生长因子1型受体(IGF-1R)的表达与卡培他滨联合奥沙利铂(XELOX)方案化疗疗效的关系。方法:收集56例一线接受XELOX化疗的晚期胃癌患者的临床、病理资料,采用免疫组化法检测其IGF-1R的表达情况,计算客观有效率(ORR)和疾病控制率(DCR),统计分析IGF-1R的表达与胃癌患者临床病理特征、近期疗效、临床受益率及毒副反应发生情况的关系。结果:56例患者中,IGF-1R的阳性率为69.6%,其中未分化-低分化腺癌患者IGF-1R的阳性率显著高于中-高分化腺癌(76.5%vs.59.1%,P<0.05)。56例患者的ORR为28.6%,DCR为55.3%。与IGF-1R(-)的胃癌患者相比,IGF-1R(+)的胃癌患者ORR、DCR及临床受益率均显著降低(ORR:23.1%vs.41.1%;DCR:48.7%vs.70.5%;临床受益率:51.3%vs.70.6%)(P<0.05)。IGF-1R的表达与XELOX方案所致化疗毒副反应无显著相关性(P>0.05)。结论:IGF-1R的表达可能成为预测胃癌化疗疗效及预后的新指标,IGF-1R(-)的胃癌患者可能更能从XELOX化疗方案中获益。
Objective: To investigate the relationship between the expression of insulin-like growth factor 1 receptor (IGF-1R) and the efficacy of capecitabine and oxaliplatin chemotherapy in advanced gastric cancer. Methods: The clinical and pathological data of 56 patients with advanced gastric cancer receiving first-line XELOX chemotherapy were collected. The expression of IGF-1R was detected by immunohistochemistry, and the objective and effective rate (ORR) and disease control rate (DCR) The relationship between the expression of IGF-1R and the clinicopathological characteristics, short-term curative effect, clinical benefit rate and the occurrence of toxic and side reactions in patients with gastric cancer. Results: In 56 patients, the positive rate of IGF-1R was 69.6%. The positive rate of IGF-1R in patients with undifferentiated-poorly differentiated adenocarcinoma was significantly higher than that in moderate-poorly differentiated adenocarcinoma (76.5% vs.59.1%, P <0.05). The 56 patients had an ORR of 28.6% and a DCR of 55.3%. The ORR, DCR and clinical benefit rates of patients with IGF-1R (+) gastric cancer were significantly lower than those of patients with IGF-1R (-) gastric cancer (ORR: 23.1% vs.41.1%; DCR: 48.7% vs.70.5% ; Clinical benefit rate: 51.3% vs.70.6%) (P <0.05). There was no significant correlation between the expression of IGF-1R and the toxicity of chemotherapy induced by XELOX regimen (P> 0.05). CONCLUSIONS: The expression of IGF-1R may be a new predictor of the efficacy and prognosis of gastric cancer chemotherapy. Patients with gastric cancer with IGF-1R (-) may be more likely to benefit from XELOX chemotherapy.