HER-2低表达与HER-2阴性早期乳腺癌临床与病理特征及NACT效果对比  

Comparative analysis of clinical and pathological features and neoadjuvant chemotherapy efficacy between HER-2 low expression and HER-2 negative early breast cancer

作　　者：段帅 地力木拉提·艾斯木吐拉[1] 郭晨明 李慧芳[1] DUAN Shuai;DILIMULATI·Aisimutula;GUO Chenming;LI Huifang(Department of breast surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院乳腺外科,新疆乌鲁木齐830054

出　　处：《西部医学》2024年第2期262-267,共6页Medical Journal of West China

基　　金：省部共建中亚高发病成因与防治国家重点实验室项目(SKL-HIDCA-2021-41)。

摘　　要：目的 探讨人表皮生长因子受体-2(HER-2)低表达与HER-2阴性早期乳腺癌临床与病理特征及新辅助化疗(NACT)效果的差异性。方法 收集2018年1月—2022年7月于我院行NACT及手术治疗的137例早期乳腺癌患者的临床资料行回顾性分析,根据化疗前HER-2状态分为HER-2低表达组(HER2-low组,n=94)和HER-2阴性组(HER2-zero组,n=43),并进一步依据激素受体状态(HR+/-)分为HR+/HER2-low组(n=74)、HR+/HER2-zero组(n=28)、HR-/HER2-low组(n=20)、HR-/HER2-zero组(n=15)四个亚组;对比分析两组及亚组间的年龄、BMI、月经状态、分子亚型、组织学分级,TNM分期、化疗方案和周期、手术方式,NACT前后雌孕激素受体和Ki-67状态,NACT后靶病灶客观缓解率和腋窝淋巴结缩小比例,术后腋窝淋巴结病理状态和病理M&P分级,组间及亚组间pCR率等。结果 HER2-low组患病率显著高于HER2-zero组(P<0.05);HER2-low组与HER2-zero组一般资料差异无统计学意义(P>0.05);HER2-low组雌激素受体阳性率和Ki-67<35%的比例显著高于HER2-zero组,而在靶病灶客观缓解率(ORR)和HR-亚组中的pCR率显著降低,同时对比发现HR-/HER2-low亚组具有较高的组织学分级和较低的Ki-67<35%状态,差异均有统计学意义(P<0.05);HER2-low组与HER2-zero组在腋窝淋巴结缩小比例、术后腋窝淋巴结病理状态及组间pCR率等其他预后指标方面差异无统计学意义(P>0.05)。结论 HER-2低表达较HER-2阴性早期乳腺癌患病率高,且具有较高的雌激素受体阳性率和较低的Ki-67状态,缩瘤效果较差,并在激素受体阴性亚组中的pCR率显著降低,同时发现低pCR率与较高的组织学等级和较低的Ki-67状态相关。Objective To retrospectively analyze and evaluate the differences in clinical and pathological characteristics and neoadjuvant chemotherapy(NACT)efficacy between HER-2 low expression and HER-2 negative early breast cancer.Methods The clinical data of 137 patients with early breast cancer who underwent NACT and surgical treatment in our hospital from January 2018 to July 2022 were retrospectively collected,and they were divided into HER-2 low expression group(HER2-low group,n=94)and HER-2 negative group(HER2-zero group,n=43),and according to hormone receptor status(HR+/-)were further divided into four subgroups of HR+/HER2-low group(n=74)and HR+/HER2-zero Group(n=28)of HR-/HER2-low group(n=20)and HR-/HER2-zero group(n=15).The age,BMI,menstrual status,molecular subtype,histological grade,TNM stage,chemotherapy scheme and cycle,operation method,estrogen progesterone receptor and Ki-67 status before and after NACT,objective response rate of target lesion after NACT and reduction ratio of axillary lymph node,pathological status of axillary lymph node and pathological M&P grade after operation,and pCR rate between groups and subgroups were compared and analyzed.Results The prevalence in the HER2-low group was significantly higher than that in the HER2-zero group.In the absence of statistical differences in general data between the two groups,the positive rate of estrogen receptor and the proportion of Ki-67<35%in HER2-low group were significantly higher than those in HER2-zero group,while the objective response rate of target lesions and the pCR rate in hormone receptor negative subgroup were significantly reduced,and the HR-/HER2-low subgroup had higher histological grade and lower Ki-67 status with statistically significant differences(P<0.05).However,there were no significant differences in axillary lymph node shrinkage ratio,postoperative axillary lymph node pathological status and pCR rate between the two groups(P>0.05).Conclusion The prevalence of early breast cancer with HER-2 low expression is high,and it has a

关 键 词：乳腺癌 HER-2低表达 临床特征 分子表达 

分 类 号：R737.9[医药卫生—肿瘤]