微卫星不稳定性和新辅助化疗后结合紫杉醇胃癌性别特异性生存差异：一项真实世界患者的观察研究。
Microsatellite instability and sex-specific differences of survival in gastric cancer after neoadjuvant chemotherapy without and with taxane: An observational study in real world patients.
发表日期：2023 Mar 31
作者：
Theresa Hiltner, Meike Kohlruss, Anna-Lina Herz, Sylvie Lorenzen, Alexander Novotny, Alexander Hapfelmeier, Moritz Jesinghaus, Julia Slotta-Huspenina, Leila Sisic, Matthias M Gaida, Wilko Weichert, Katja Ott, Gisela Keller
来源：
Best Pract Res Cl Ob
摘要：
调查微卫星不稳定性（MSI）对接受铂类/氟嘧啶新辅助化疗（CTx）的患者性别的预后作用，包括联合含紫杉醇化合物和单独氟嘧啶治疗的影响。回顾性分析了505例胃癌或胃食管腺癌患者，其中411例患者接受了不含紫杉醇的治疗，94例患者接受了含紫杉醇的治疗。MSI使用标准化测定方法进行评估。在不含紫杉醇的组中，女性的总体生存率（OS）优于男性（HR 0.59；95％CI 0.41-0.86；p = 0.005），而在含紫杉醇的组中未发现显着差异（HR1.22；95％CI 0.55-2.73，p = 0.630）。在两组中，MSI高（-H）与良好的预后相关（未使用紫杉醇，HR 0.56；95％CI 0.33-0.97；p = 0.038；使用紫杉醇，HR 0.28；95％CI 0.04-2.02，p = 0.204）。在不使用紫杉醇的组中，女性MSI-H患者表现出最佳的OS（HR 0.18，95％CI 0.05-0.73，p = 0.016），其次是女性微卫星稳定（MSS）组（HR 0.67，95％CI 0.46-0.98，p = 0.040），男性MSI-H组（HR 0.76；95％CI 0.42-1.37，p = 0.760），男性MSS组为参考。在紫杉醇组中，女性和男性MSI-H患者表现出最佳的OS（女性MSI-H，HR 0.05，95％CI 0.00-240.46；男性MSI-H，HR 0.45，95％CI 0.61-3.63，p = 0.438），而女性MSS组的OS下降（HR 1.39，95％CI 0.62-3.12，p = 0.420），与男性MSS患者相比。化疗方案中使用紫杉醇化合物和未使用紫杉醇化合物的患者，胃/胃食管癌的CTx后OS可能取决于性别和MSI状态，可能存在差异。 ©2023年作者（S）。
To investigate the prognostic role of microsatellite instability (MSI) in association with sex of patients treated with platinum/fluoropyrimidine neoadjuvant chemotherapy (CTx) with or without a taxane-containing compound.Of the 505 retrospectively analyzed patients with gastric or gastroesophageal adenocarcinoma, 411 patients were treated without taxane and 94 patients with a taxane-containing compound. MSI was determined using standard assays.Females demonstrated a better overall survival (OS) than males in the non-taxane group (HR, 0.59; 95% CI 0.41-0.86; p = 0.005), whereas no significant difference was found in the taxane group (HR 1.22; 95% CI 0.55-2.73, p = 0.630). MSI-High (-H) was associated with a better prognosis in both groups (without taxane: HR 0.56; 95% CI 0.33-0.97; p = 0.038; with taxane: HR 0.28; 95% CI 0.04-2.02, p = 0.204). In the non-taxane group, female MSI-H patients showed the best OS (HR 0.18, 95% CI 0.05-0.73; p = 0.016), followed by the female microsatellite stable (MSS) (HR 0.67, 95% CI 0.46-0.98, p = 0.040) and the male MSI-H group (HR 0.76; 95% CI 0.42-1.37, p = 0.760) taken the male MSS group as reference. In the taxane group, female and male MSI-H patients demonstrated the best OS (female MSI-H: HR 0.05, 95% CI 0.00-240.46; male MSI-H: HR 0.45, 95% CI 0.61-3.63, p = 0.438), whereas the female MSS group showed a decreased OS (HR 1.39 95% CI 0.62-3.12, p = 0.420) compared to male MSS patients.OS in gastric/gastroesophageal cancer after CTx might depend on sex and MSI status and may differ between patients treated with or without a taxane compound in the chemotherapeutic regimen.© 2023. The Author(s).