Gastric Cancer: Early detection of disease, relapse and prediction of extent of disease

胃癌(GC)是世界上第二常见的癌症病因。胃癌的主要治疗方法是手术切除，但尽管手术干预措施有所改善，但死亡率仍然很高。胃癌的5年生存率约为30%。准确的分期对GC的管理至关重要，目前的研究还不够充分。现在已经有可能通过测量数千个基因的活性来识别那些预测患者是否会存活或死于疾病的基因。我们建议使用基因表达谱来预测患者的胃癌复发风险。我们将检查270多个肿瘤，并使用一组独立的患者来评估这项测试。我们的目标是开发一种测试，帮助临床医生决定要进行的手术切除类型或是否给予辅助化疗。这项测试还可能指导更具体的抗癌药物的使用。早期发现GC非常重要，因为早期GC患者预后较好。我们已经用微阵列分析了60多个GC肿瘤，并发现了肿瘤特异性表达的基因，这些肿瘤是潜在的癌症标志物。我们计划检查更多的GC病例，既是为了发现更多的基因，也是为了验证我们的候选基因作为肿瘤标志物的有效性。我们还想寻找患者血液中识别GC的蛋白质模式，并使用这种模式跟踪患者的进展到治疗。

Gastric cancer (GC) is the second commonest cause of cancer in the world. The mainstay of treatment for GC is surgical resection, but despite improvements in surgical interventions the mortality rate remains high. The 5 year survival rate of GC is about 30% over 5 years. Accurate staging is fundamental to the management of GC and current investigations are inadequate. It has become possible to measure the activity of thousands of genes to identify those genes that predict whether a patient will survive or succumb to their disease. We propose to use gene expression profiling to predict the risk of recurrence of gastric cancer in patients. We will examine over 270 tumours and use an independent group of patients to evaluate the test. We aim to develop a test that will help the clinician decide the type of surgical resection to perform or whether to give adjuvant chemotherapy. The test may also guide the use of more specific anticancer drugs. Early detection of GC is very important because patients with early stage GC have better outcome. We have already analysed over 60 GC tumours with microarrays and found genes that are specifically expressed by the tumours that are potential candidates as cancer markers. We plan to examine more cases of GC, both to find more genes and validate our candidate genes as tumour markers. We also want to look for patterns of proteins in blood of patients that identifies GC and use this pattern to follow patient progress to treatment.