Abstract: Objective To investigate the association of TOP2A with the efficacy of adjuvant chemotherapy and epirubicin in gastric cancer.
Methods Patients with gastric adenocarcinoma who had received radical gastrectomy of D2 and adjuvant chemotherapy after surgery were selected. The expression of TOP2A protein in paraffin-embedded tumor tissues was detected by immunohistochemistry， and its correlations with diseasefree survival （DFS） and overall survival （OS） of patients were analyzed.
ResultsA total of 109 patients were enrolled including 44 epirubicintreated patients. The expression level of TOP2A protein was not relative with clinicopathologic characteristics of gastric cancer（P＞0.05）. Kaplan-Meier survival analyses showed that the 3-year diseasefree survival rate and 3year overall survival rate in patients with low expression of TOP2A protein were higher than those with high expression （79.8％ vs. 57.1％ and 88.0％ vs. 65.0％， respectively； both P＜0.05）. In patients with gastric cancer treated with epirubicin adjuvant chemotherapy， such superiority associated with low expression of TOP2A protein was also observed for DFS （83.3％ vs. 50.0％； P＜0.05） and OS had a trend to be significantly different （91.7％ vs. 62.2％； P=0.068）. Furthermore， Multivariate Cox regression proportional hazard analysis showed that histological grade of Ⅲ （HR=3.02， 95％CI：1.41~6.46； P=0.004） and TOP2A high expression （HR=3.51， 95％CI：1.06~11.58； P=0.039） were the independent risk factor of OS in gastric cancer. Conclusion The TOP2A expression may be associated with the efficacy of adjuvant chemotherapy and epirubicin in gastric cancer， and it is a potential molecular marker for efficacy prediction.