HER-2/neu过度表达在淋巴结阴性乳腺癌中的预后价值  

The prognosis of HER-2/neu expression in axillary lymph node-negative breast cancer patients

作　　者：刘毅[1] 曹道成[1] 后强[1] 张俊坤[1] 崔杰[1] 李鹤成[2] 邵志敏[2] 

机构地区：[1]安徽省马鞍山市马钢医院外科,安徽马鞍山243000 [2]复旦大学附属肿瘤医院乳腺外科,上海200032

出　　处：《安徽医药》2005年第12期913-915,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的研究HER-2/neu过度表达在淋巴结阴性乳腺癌中的预后意义.方法对1990～1998年收住的137例腋淋巴结阴性乳腺癌患者肿瘤标本,用免疫组织化学方法检测肿瘤细胞HER-2/neu的表达.分析HER-2/neu的表达与其他临床病理预后指标的相关性.单因素和多因素的方法检测HER-2/neu的过度表达作为预后指标对无复发生存率(RFS)和总生存率(OS)的重要性.结果结果显示HER-2/neu过度表达和其他临床病理指标无关.HER-2/neu过度表达患者的无复发生存率及总生存率显著低于HER-2/neu低表达患者 (P=0.0121和0.0301).对激素受体阳性患者,HER-2/neu过度表达患者的无复发生存率显著低于HER-2/neu低表达患者 (P=0.0011),但对激素受体阴性患者HER-2/neu状态与RFS无关;多因素分析显示 HER-2/neu、肿瘤大小、 p53是影响RFS的独立预后因子.结论在腋淋巴结阴性的乳腺癌患者中,HER-2/neu过度表达与雌激素受体相结合可以更好的判定患者的预后.Aim To evaluate the prognostic value of HER-2/neu over-expression in node-negative patients. Methods Specimens from the primary tumors ofl37axillary lymph node negative patients who underwent surgery between 1990～1998 were studied. Immunohistochemical analysis of HER-2/neu protein expression in breast carcinoma samples was performed. We analyze the association of HER-2/ neu over-expression with other clinic-pathological factors by chi-square test. Univariate and multivariate analysis were performed to evaluate the prognostic significanceof HER-2/neu over-expression in relapse free survival （RFS） and overall survival （OS）. Results We found HER-2/neu over-expression had no correlation with other clinic-pathological factors （such as menopausal status,tumorsize,tumor grade,p53,ER and histotype）. The over-expression of HER-2/neu is significantly correlation with RFSand OS in node-negative patients （p =0. 0121,0. 0301 ）. We also found over-expression of HER-2/neu is a significantly unfavorable prognostic factor for RFS in steroid receptor positive patients（ p = 0. 0011 ） ,but not ER negative patients. Multivariate analysis showed that HER-2/neu together with tumor size and p53 was independently prognostic actor for RFS in node-negative patients （ P 〈 0.05 ）. Conclusion We concluded that for lymph node-negative patients, HER-2/neu over-expression combined with steroid receptor status can be meaningful to patients` prognosis.

关 键 词：乳腺肿瘤/病理学 HER-2/NEU 雌激素受体 淋巴结阴性 预后 淋巴结阴性乳腺癌 过度表达 预后价值 无复发生存率 乳腺癌患者 

分 类 号：R737.9[医药卫生—肿瘤] R735.2[医药卫生—临床医学]