表皮生长因子受体-2和雌激素受体对晚期乳腺癌应用紫杉类药物疗效的预测分析  

HER-2 and ER expression in prediction of chemo-sensitivity of taxane for advanced breast cancer

作　　者：刘芳[1] 江泽飞[2] 宋三泰[2] 孙君重[1] 张少华[2] 冯胜强[3] 

机构地区：[1]解放军总医院第一附属医院,北京100037 [2]军事医学科学院307医院 [3]总参警卫局保健处

出　　处：《中华肿瘤杂志》2006年第6期449-451,共3页Chinese Journal of Oncology

摘　　要：目的研究表皮生长因子受体-2(HER-2)和雌激素受体(ER)对乳腺癌应用紫杉类药物化疗疗效的预测作用。方法268例晚期乳腺癌应用紫杉类药物化疗,其中单药紫杉醇71例,单药泰索帝32例,紫杉醇联合组110例,泰索帝联合组55例。应用免疫组化的方法对患者的ER和HER-2生物学指标在蛋白水平进行检测。268例中,行HER-2检测201例,行ER检测242例,行HER-2和ER两项检测者200例。结果HER-2过表达有效率为56．7%,低表达有效率为33．3%,两组差异有统计学意义(P=0．003)。ER阳性有效率为33．3%,ER阴性患者有效率为48．9%,两组差异有统计学意义(P=0．015)。在HER-2过表达同时ER阴性患者的有效率高达67．6%,其他组各组均在35%左右,HER-2过表达同时ER阴性与其他3组进行两两比较,差异有统计学意义(P＜0．01)；而其他3组之间差异无统计学意义。多因素分析显示HER-2过表达仍有统计学意义(P= 0．007)。而ER受体以及KPS评分、蒽环类药物、转移部位均不具有统计学意义。结论HER-2过表达和(或)ER阴性,尤其HER-2过表达对紫杉类药物的疗效可能有预测作用,HER-2过表达可能是乳腺癌紫杉类化疗效果好的分子指标。Objective To investigate the predictive value of HER-2 and ER expression for chemosensitivity of taxane in the treatment of advanced breast cancer. Methods Of 268 advanced breast cancer patients treated： 71 were by paclitaxel alone, 32 by docetaxel alone, 110 by paclitaxel combined with anthracylines or gemcitabine or platins and 55 by docetaxel-based combinations. HER-2 and ER expression of all patients treated by taxane underwent immunohistochemical （IHC） assay. Results Univariate analysis showed： the response rate （RR） in HER-2 overexpression group was 56. 7%, and in HER-2 weak expression group 33.3% （P =0.003）. The response rate in ER positive group and ER negative group was 33.3% and 48.9%, respectively, with a significant difference （ P = 0.015 ）. The RR was 67.6% in ER negative but HER-2 overexpression group. However, in ER positive but HER-2 weak expression group and the other groups, the RR were around 35% （P 〈0.01 ）. Multivariate analysis showed that overexpression of HER-2 was the only significant factor to predict the chemosensitivity of taxane （ P = 0.007 ）, but the ER, Karnofsky performance score （KPS）, anthracylines, metastatic sites were not the statistically significant chemo-sensitivity predictive factors for taxane. Conclusion ER negative and/or HER-2 overexpression, especially latter, may be associated with good response in advanced breast cancers treated by taxane.

关 键 词：HER-2 ER 乳腺癌 紫杉类药物 

分 类 号：R737.9[医药卫生—肿瘤]