人表皮因子受体-2在膀胱尿路上皮癌和上尿路上皮癌中表达的差异性分析  

Differential analysis of HER-2 expression in urothelial bladder carcinoma and upper urothelial carcinoma

作　　者：刘建兵 岳中瑾[1] 常宏[1] 尚攀峰[1] 刘雅婷[1] LIU Jianbing;YUE Zhongjin;CHANG Hong;SHANG Panfeng;LIU Yating(Department of Urology,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院泌尿外科,甘肃兰州730030

出　　处：《现代泌尿外科杂志》2024年第5期421-426,431,共7页Journal of Modern Urology

基　　金：萃英科技创新项目(No.CY2021-MS-A11)。

摘　　要：目的探索人表皮因子受体-2(HER-2)在膀胱尿路上皮癌(UBC)和上尿路上皮癌(UTUC)中表达的差异性,及其与这两种疾病复发及进展的相关性。方法回顾性分析2015年11月—2022年6月兰州大学第二医院泌尿外科收治的184例尿路上皮癌患者,按照肿瘤部位分为UBC组及UTUC组,比较两组中HER-2的阳性表达率,绘制生存曲线。比较两组患者的无复发生存期(RFS)及无进展生存期(PFS)。应用Cox比例风险模型分析HER-2阳性表达对UBC及UTUC患者复发及进展的影响。结果UBC患者HER-2阳性表达显著高于UTUC患者(49.6%vs.32.2%,P=0.027)。UTUC患者中,肾盂癌患者HER-2阳性表达相较于输尿管癌差异无统计学意义(30.6%vs.34.8%,P>0.05)。Cox多因素回归分析显示HER-2阳性表达影响UBC复发(P<0.001);HER-2阳性表达(P<0.001)、肿瘤直径≥3 cm(P<0.001)、分期≥T2(P=0.003)以及多发肿瘤灶(P=0.033)均可影响UBC进展;HER-2阳性表达对UTUC复发及进展的影响差异无统计学意义。结论UBC组患者HER-2的阳性表达显著高于UTUC,HER-2阳性表达可能提示UBC复发及进展的风险增加,而对UTUC的复发及进展则无明显影响。因此不建议以HER-2表达来独立预测UTUC的复发及进展风险。Objective To investigate the differences in human epidermal factor receptor 2(HER-2)expression between urothelial bladder carcinoma(UBC)and upper tract urothelial carcinoma(UTUC)and the relationship between HER-2 expression and disease recurrence and progression.Methods Clinical data of 184 patients with urothelial carcinoma admitted in our hospital during Nov.2015 and Jun.2022 were retrospectively analyzed.The patients were divided into UBC group and UTUC group.The positive expression rate of HER-2,recurrence-free survival(RFS)and progression-free survival(PFS)of the two groups were compared,and the survival curve was drawn.The effects of HER-2 expression on the recurrence and progression of disease were analyzed with Cox proportional hazards model.Results The positive expression of HER-2 was significantly higher in UBC patients than in UTUC patients(49.6%vs.32.2%,P=0.027).Among UTUC patients,there was no statistically significant difference in the positive expression of HER-2 in those with renal pelvis cancer and ureteral cancer(30.6%vs.34.8%,P>0.05).Cox analysis showed that HER-2 positive expression affected UBC recurrence(P<0.001),but had no effects on the recurrence and progression of UTUC;HER-2 positive expression(P<0.001),tumor diameter≥3 cm(P<0.001),stage≥T2(P=0.003)and multiple tumor foci(P=0.033)affected the progression of UBC.Conclusion The positive expression of HER-2 is significantly higher in UBC than in UTUC,which can increase the risk of recurrence and progression of UBC,but has no significant effects on the recurrence and progression of UTUC.HER-2 expression is not recommended to independently predict the risk of recurrence and progression of UTUC.

关 键 词：人表皮因子受体-2 膀胱尿路上皮癌 上尿路上皮癌 肿瘤复发 肿瘤进展 

分 类 号：R737.14[医药卫生—肿瘤]