在胃和胃食道接口腺癌中,克劳丁18. 2和其他治疗生物标志物
Bella L Liu1, James M Cleary2, Jay Shi1
1Department of Pathology, Brigham and Women's Hospital.
The American journal of surgical pathology
|August 27, 2025
概括
克劳丁18. 2 (CLDN18. 2) 是胃和食道结癌的一个有前途的生物标志物,特别是在三阴性病例中. 它的表达扩大了患者可行的生物标志物选择,尽管潜在的异质性需要仔细评估.
科学领域:
- 癌症学
- 胃肠病学
- 分子病理学
背景情况:
- 生物标志物驱动的疗法已推进胃和食道结 (GEJ) 癌症的治疗.
- 关键生物标志物的联合表达模式,包括Claudin 18. 2 (CLDN18. 2),HER2,PD- L1和不匹配修复 (MMR) 状态,尚未完全理解.
- 了解这些重叠对于优化向治疗策略至关重要.
研究的目的:
- 在胃和GEJ腺癌中分析CLDN18.2,HER2,PD-L1和MMR的同时表达.
- 评估CLDN18.2的染色程度和临床病理相关性.
- 确定包括CLDN18.2在可操作生物标志物的患者比例的影响.
主要方法:
- 对145例胃腺癌和GEJ腺癌的回顾性分析 (2023-2024年).
- 根据≥75%的中度至强度的膜色彩被归类为CLDN18.2阳性瘤.
- 评估与HER2,PD- L1和MMR状态的同时表达;评估临床病理特征和内异质性.
主要成果:
- 在48%的病例中发现了CLDN18. 2阳性,并丰富了密封环细胞特征 (P=0. 0113,多变量).
- 在CLDN18. 2和HER2,PD- L1或MMR状态之间没有发现显著的相关性.
- 包括CLDN18. 2的可操作生物标志物阳性增加到92%;52%的三阴性瘤是CLDN18. 2阳性的.
结论:
- CLDN18.2是胃/大肠瘤的重要生物标志物,特别是在三阴性病例中,扩大了治疗选择.
- 虽然CLDN18.2表达的异质性相对较低,但采样问题仍然存在.
- 这项研究阐明了生物标志物,强调了CLDN18.2在个性化治疗中的作用.
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