Background:Gastric cancer is a major global health burden. Although neoadjuvant chemotherapy and conversion surgery can improve survival, treatment responses vary owing to chemotherapy resistance. Cancer stem cells (CSCs), characterized by self-renewal and drug resistance, are closely linked to treatment efficacy and prognosis. Among these, CD44 variant 9 (CD44v9) plays an important role in redox regulation and chemoresistance. Although its expression in resected gastric cancer specimens has been associated with poor prognosis, little is known about its expression in pretreatment biopsies and its relationship with therapeutic responses. This study aimed to clarify the predictive value of CD44v9 expression in gastric cancer biopsy specimens.Methods:Pretreatment biopsy specimens from 84 patients with gastric cancer who underwent neoadjuvant chemotherapy or conversion surgery at our institution were analyzed. Associations between CD44v9 expression, histological response, and prognosis were evaluated.Results:High CD44v9 expression was observed in 25% of patients and was significantly associated with a poor histological response (p= 0.046). Although CD44v9 expression was not directly linked to prognosis, a poor histological response correlated with worse survival (p= 0.045). In the multivariate analysis, conversion surgery (p= 0.018) and poor histological response (p= 0.011) were identified as independent predictors of poor outcomes.Conclusions:Evaluation of CD44v9 expression in pretreatment biopsies may help predict chemotherapy resistance in patients with gastric cancer. This biomarker assessment could guide individualized treatment strategies and improve patient management outcomes.
背景：胃癌是全球主要的健康负担。尽管新辅助化疗和转化手术能够提高生存率，但由于化疗耐药性，治疗反应存在差异。具有自我更新和耐药特性的癌症干细胞与治疗效果及预后密切相关。其中，CD44变异体9在氧化还原调节和化疗耐药中发挥重要作用。虽然其在切除的胃癌标本中的表达与不良预后相关，但关于其在治疗前活检中的表达及其与治疗反应的关系知之甚少。本研究旨在阐明胃癌活检标本中CD44v9表达的预测价值。 方法：分析了我院接受新辅助化疗或转化手术的84例胃癌患者的治疗前活检标本。评估了CD44v9表达、组织学反应及预后之间的关联。 结果：25%的患者观察到CD44v9高表达，且与不良组织学反应显著相关（p=0.046）。尽管CD44v9表达与预后无直接关联，但不良组织学反应与较差的生存率相关（p=0.045）。多变量分析显示，转化手术（p=0.018）和不良组织学反应（p=0.011）是不良预后的独立预测因素。 结论：评估治疗前活检中的CD44v9表达可能有助于预测胃癌患者的化疗耐药性。该生物标志物评估可指导个体化治疗策略，改善患者管理效果。
肿瘤(癌症)患者之家