人乳腺癌表皮生长因子受体2低表达的病理特征及动态变化分析  

Pathological characteristics and dynamic changes analysis of low human epidermal growth factor 2 expression in breast cancer

作　　者：王梦琪 白雪峰[2] 赵志英[1] WANG Mengqi;BAI Xuefeng;ZHAO Zhiying(Department of Human Anatomy,Baotou Medical College,Baotou 014040,China;Department of Pathology,Baotou Cancer Hospital)

机构地区：[1]包头医学院人体解剖学教研室,内蒙古包头014040 [2]包头市肿瘤医院病理科

出　　处：《包头医学院学报》2025年第2期69-74,共6页Journal of Baotou Medical College

摘　　要：目的:研究人乳腺癌表皮生长因子受体2(human epithelial growth factor receptor-2,HER2)低表达的病理特征,通过RT-qPCR检测HER2的表达水平,追踪从穿刺活检到接受新辅助化疗后HER2表达的演变,探索其新辅助化疗的疗效。方法:选取2019年1月-2022年12月包头市肿瘤医院收治的293例浸润性乳腺癌患者(HER2阴性型134例,HER2低表达型159例),分别应用FISH及RT-qPCR检测两组患者HER2表达水平。结果:与HER2阴性组相比,HER2低表达组在雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、Miller-Payne(MP)分级、P53及淋巴结转移差异具有统计学意义(P<0.05);与年龄(P=0.731)差异无统计学意义;FISH检测结果显示两组数据显著重叠;RT-qPCR检测mRNA表达量,两组差异具有统计学意义(P<0.001);采用ROC曲线明确最佳阈值为184.18;RT-qPCR与IHC相比,两种检测方法的一致性为0.502,属中等水平;新辅助化疗前后,HER2不一致的发生率为39.8%;HER2状态与获得pCR的概率之间存在密切相关(P=0.005)。结论:乳腺癌HER2低表达与阴性的病理特征不同。RT-qPCR检测HER2 mRNA的表达量可作为IHC检测HER2低表达的补充技术。HER2的表达在新辅助治疗后表现出高度不稳定性。此外,HER2低表达乳腺癌患者的新辅助化疗的疗效较差。Objective:To study the pathological characteristics of low HER2 expression in human breast cancer,detect the expression level by RT-qPCR,track the evolution of HER2 expression from needle biopsy to receive neoadjuvant treatment,and explore the efficacy of neoadjuvant chemotherapy.Methods:A total of 293 HER2 negative patients and low HER2 expression admitted to Baotou Cancer Hospital from January 2019 to December 2022 were selected.FISH and RT-qPCR were used to detect the expression level of HER2 in the two groups.Results:In contrast to the HER2 negative group,low expression group of HER2 was significant statistical differences in ER,PR,MP grade,P53 and lymph node metastasis(P<0.05);There was no obvious relationship with age(P=0.731);The results of FISH analysis showed that the data of the two groups were significantly overlapped;and the mRNA expression level of RT-qPCR was a statistical difference(P<0.001).The optimal threshold by ROC curve was 184.18.RT-qPCR compared to IHC,the consistency between the two methods was 0.502,a medium level.Before and after neoadjuvant chemotherapy,the incidence of HER2 discordance was 39.8%;There is a close correlation between HER2 status and the probability of obtaining pCR(P=0.005).Conclusion:HER2 low breast cancer differ from HER2 negative in pathological features.Quantitative detection of HER2 mRNA expression by RT-qPCR can be used as a complementary technique for IHC method.The expression of HER2 showed high instability following neoadjuvant therapy.Moreover,neoadjuvant chemotherapy has less efficacy in patients with HER2 low breast cancer.

关 键 词：乳腺癌 人类表皮生长因子受体2低表达 病理特征 动态变化 

分 类 号：R737.9[医药卫生—肿瘤]