HER-2低表达乳腺癌的病理特征及其对新辅助化疗的影响  

Pathological features of HER-2 hypoexpression breast cancer and its effect on neoadjuvant chemotherapy

作　　者：王晶 王楠[2] 邱献华[1] Jing WANG;Nan WANG;Xian-Hua QIU(The Third Department of General Surgery,Anyang Cancer Hospital,Anyang 455001,Henan Province,China;Department of Breast Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]安阳市肿瘤医院外三科,河南安阳455000 [2]郑州大学第一附属医院乳腺外科,郑州450052

出　　处：《数理医药学杂志》2023年第4期282-287,共6页Journal of Mathematical Medicine

基　　金：河南省医学科技攻关计划项目(SBGJ202103070)。

摘　　要：目的探讨人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阴性乳腺癌患者中HER-2不同表达状态的临床病理特征及其对乳腺癌新辅助化疗的影响。方法收集2019年1月至2022年1月安阳市肿瘤医院收治的HER-2阴性乳腺癌患者572例,根据HER-2表达情况,将其分为HER-20组(免疫组化为0)和HER-2低表达组(免疫组化为1+或2+,FISH结果为阴性)。比较两组的临床病理学特征。其中新辅助化疗患者252例,分析其临床病理特征与新辅助治疗病理完全缓解(pathologic complete response,pCR)之间的关系。结果纳入研究的患者中位年龄49(27~75)岁,HER-20组、HER-21+组、HER-22+组的比例分别为48.50%、31.29%、20.45%;HR阳性患者中HER-2低表达比例明显高于HR阴性患者(59.38%vs.36.36%,P<0.001)。HER-2低表达组患者T3+4比例(12.50%vs.2.54%,P<0.001)、N3比例(12.84%vs.3.62%,P<0.001)显著高于HER-20组患者,但Ki-67的高表达率较低(31.08%vs.52.90%,P<0.001)。不论HR阳性还是阴性患者,HER-2低表达患者新辅助化疗pCR率均低于HER-20组,分别为(7.29%vs.15.38%,P=0.119)、(25.0%vs.40.0%,P=0.110),但差异无统计学意义。结论HER-2低表达与HER-20有着不同的临床病理学特征,HER-2阴性患者中,HER-2不同表达状态不是新辅助治疗pCR的影响因素。Objective To explore the clinicopathological features of different expression states of HER-2 in patients with HER-2-negative breast cancer and their effect on neoadjuvant chemotherapy for breast cancer.Methods A total of 572 patients with HER-2 negative breast cancer admitted to Anyang Cancer Hospital from January 2019 to January 2022 were collected and based on HER-2 expression,divided into HER-20(immunohistochemistlization 0)and HER-2 low expression groups(immunohistochemistlization1+or 2+(negative FISH results).The clinicopathological characteristics of the two groups were compared.Among them,252 cases underwent neoadjuvant chemotherapy.The relationship between clinicopathological feature and pathologic complete response were analyzed.Results The median age of the included patients was 49(27~75),and the proportion of HER-20,HER-21+,and HER-22+patients were 48.5%,31.29%,and 20.45%,respectively,and the proportion of HER-2 low expression was significantly higher in HR+patients than in HR-negative patients(59.38%vs.36.36%,P<0.001).The proportions of T3+4(12.5%vs.2.54%,P<0.001)and N3(12.84%vs.3.62%,P<0.001)were significantly higher in the HER-2 low expression than in the HER-20 group,but the high expression of Ki-67 was lower(31.08%vs.52.90%,P<0.001).No matter in HR+(7.29%vs.15.38%,P=0.119)or HR-group(25.0%vs.40.0%,P=0.110),patients with HER-2 low expression had lower pCR rates than HER-20 patients,but it was not statistically significant.Conclusion HER-2 low expression has different clinicopathological features from HER-20,and neither HER-2 low expression nor HER-20 is an influencing factor in achieving pCR with neoadjuvant therapy.

关 键 词：乳腺癌 人类表皮生长因子受体-2 临床病理特征 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]