Expression of ALK BRAF and Her-2 in Hp-Infected Gastric Cancer Tissues and Their Predictive Value for Poor Prognosis
Objective:To observe the expression of anagenic lymphoma kinase(ALK),murine sarcoma viral oncogenic homology B1(BRAF)and human epidermal growth factor receptor 2(Her-2)in gastric canc-er infected by Helicobacter pylori(Hp),and to analyze their prediction value of poor prognosis in HP-infec-ted gastric cancer.Methods:A total of 106 patients with Hp-infected gastric cancer admitted to the the First Hospital of Nanping Affiliated to Fujian Medical University from October 2019 to November 2022 were selected to compare the differences in the positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues and paracancerous tissues,and to analyze the relationship between the expression of ALK,BRAF,and Her-2 in gastric cancer tissues and the clinical features and pathological manifestations of Hp-in-fected gastric cancer.After 1 year of follow-up,the patients were divided into good prognosis group(61 ca-ses)and poor prognosis group(45 cases)according to their postoperative recurrence or death,and the ALK,BRAF,Her-2 expression of Hp-infected gastric cancer tissues with different prognosis were compared;the predictive efficacy and early warning value of ALK,BRAF,Her-2 expression of Hp-infected gastric cancer tissues on poor prognosis were analyzed.Results:The positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues(17.92%,67.92%,and 25.47%)were higher than those in adjacent tis-sues(2.83%,7.55%,and 4.72%)(χ2=12.984,82.230,and 17.814,P<0.05).Significant differences were observed in the positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tis-sues across different levels of tissue differentiation,infiltration,TNM staging,and lymph node metastasis(P<0.05).Among 106 patients with Hp-infected gastric cancer who underwent follow-up,45 were included in the poor prognosis group(32 relapsed and 13 died),and 61 were included in the good prognosis group.The positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues in the poor progno-sis group(35.56%,93.33%,and 46.67%)were higher than those in the good prognosis group(4.92%,49.18%,and 9.84%)(χ2=16.523,23.172,and 18.504,P<0.05).The combined assessment of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues showed the highest AUC for poor progno-sis,reaching 0.901(95%CI:0.827～0.950)(P<0.05),with a sensitivity of 86.67%and a specificity of 93.44%,and the predictive efficacy was superior to that of ALK,BRAF,and Her-2 expression detection a-lone.The RR values for poor prognosis caused by ALK,BRAF,and Her-2 positivity in Hp-infected gastric cancer were 2.526(1.771～3.604),6.611(2.205～19.821),and 2.560(1.733～3.781),respectively(P<0.05).Conclusion:The expression of ALK,BRAF and Her-2 in HP-infected gastric cancer is closely related to the degree of tissue differentiation,invasion,TNM staging,and lymph node metastasis,which has high predictive and early warning value for the adverse prognosis of HP-infected gastric cancer.
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