不同新辅助治疗方案对403例乳腺癌患者HER2表达状态的影响  

Effect of different neoadjuvant treatment regimens on human epidermal growth factor receptor 2 expression in 403 patients with breast cancer

作　　者：任晓菲 张香梅[3,2] 李静平[1,2] 王丽[4] 马祥敏 马心迪[1,2] 张伟 高源 刘北辰 贺宇彤 任曙光[9,2] 赵小涵[10] 刘运江[1,2] REN Xiao-fei;ZHANG Xiang-mei;LI Jing-ping;WANG Li;MA Xiang-min;MA Xin-di;ZHANG Wei;GAO Yuan;LIU Bei-chen;HE Yu-tong;REN Shu-guang;ZHAO Xiao-han;LIU Yun-jiang(Forth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance,Hebei Medical Universisty,Shijiazhuang 050011,China;Department of Breast Surgery,Xingtai People’s Hospital,,Xingtai054000,China;Department of Breast Surgery,Handan Central Hospital,Handan 056000,China;College of Pharmacy,Air Force Military Medical University,Xi'an 710000,China;Department of Cancer Prevention and Control,Tumor Research Institute of Hebei Province,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院乳腺中心,河北石家庄050011 [2]河北医科大学河北省肿瘤微环境与耐药重点实验室,河北石家庄050011 [3]河北医科大学第四医院科研中心,河北石家庄050011 [4]邢台市人民医院乳腺科,河北邢台054000 [5]邯郸市中心医院乳腺科,河北邯郸056000 [6]空军军医大学药学院,陕西西安710000 [7]河北医科大学第四医院血液科,河北石家庄050011 [8]河北省肿瘤研究所肿瘤防治办公室,河北石家庄050011 [9]河北医科大学第四医院动物中心,河北石家庄050011 [10]河北医科大学第四医院放疗科,河北石家庄050011

出　　处：《中华肿瘤防治杂志》2022年第9期669-673,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：河北省自然科学基金(H2020206210);百济神州科研基金(BeiGene2020.3.25)。

摘　　要：目的研究人类表皮生长因子受体2(HER2)阳性乳腺癌患者新辅助治疗前后HER2表达状态的变化。方法回顾性分析2018-01-01-2020-12-31在河北医科大学第四医院(341例)及邢台市人民医院(62例)完成新辅助治疗及手术的403例HER2阳性乳腺癌患者临床病理资料。根据新辅助方案分为曲妥珠单抗+帕妥珠单抗联合化疗组(双靶组)152例、曲妥珠单抗联合化疗组(单靶组)196例及单独化疗组55例。通过比较治疗前后HER2表达情况,分析不同新辅助治疗方案对HER2状态的变化的影响。结果403例HER2阳性乳腺癌新辅助患者达到病理完全缓解(pCR)共180例。其中双靶组、单靶组及化疗组达到pCR分别为65.79%(100/152)、35.20%(69/196)和20.00%(11/55),差异有统计学意义,χ^(2)=48.080,P<0.001。在未达到pCR(non-pCR)的223例HER2阳性乳腺癌中,新辅助治疗后患者HER2表达状态存在一定的转阴率,总体转阴率为13.00%(29/223)。其中双靶组、单靶组及化疗组转阴率分别为26.92%(14/52)、7.87%(10/127)和11.36%(5/44),差异有统计学意义,χ^(2)=11.964,P=0.002。结论新辅助治疗对HER2表达状态存在影响,这种变化在双靶组尤为明显。建议对转阴患者加强随访和HER2表达状态检测。Objective To study the changes of human epidermal growth factor receptor 2(HER2)expression in patients with HER2 positive breast cancer before and after neoadjuvant treatment.Methods A retrospective study comprising 403 patients with HER2positive breast cancer who received neoadjuvant treatment and surgery in the Fourth Hospital of Hebei Medical University(341cases)and Xingtai People’s Hospital(62cases)from January 1,2018to December 31,2020.According to the neoadjuvant regimen,the patients were divided into 3groups,including trastuzumab+pertuzumab combined chemotherapy group(152cases,dual target group),trastuzumab combined chemotherapy group(196cases,single target group)and standard chemotherapy group alone(55cases).We analyzed the influence of different neoadjuvant treatment regimens on the change of HER2status,through the expressions of HER2before and after treatment.Results A total of 180of 403patients with HER2positive breast cancer who received neoadjuvant treatment reached pathologic complete response(pCR).In the dual target group,single target group and standard chemotherapy group,pCR was achieved in65.79%(100/152),35.20%(69/196)and 20.00%(11/55),respectively.The difference was statistically significant(χ~2=48.080,P<0.001).In 223cases of HER2positive breast cancer that did not reach pCR(non-pCR),there was a certain rate of HER2expression that turned negative after neoadjuvant treatment,and the overall rate of negative was 13.00%(29/223).There were 26.92%(14/52),7.87%(10/127)and 11.36%(5/44)in the dual target group,single target group and standard chemotherapy group,respectively.The difference was statistically significant(χ~2=11.964,P=0.002).Conclusions Neoadjuvant treatment has an effect on HER2expression,especially in the dual target group.It is suggested that we should strengthen follow-up and detection of HER2expression status for patients who turn negative.

关 键 词：乳腺癌 新辅助治疗 人类表皮生长因子受体2 病理完全缓解 靶向治疗 

分 类 号：R737.9[医药卫生—肿瘤]