摘要
目的:探讨乳腺癌新辅助治疗(neoadjuvant therapy,NAT)前后人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)低表达及其变化和临床意义。方法:收集458例接受NAT的乳腺癌患者资料,对比分析不同HER-2状态临床病理特征及病理完全缓解(pathological complete response,pCR)率的差异,并对NAT前后HER-2状态进行一致性检验。结果:HER-2低表达组与阴性组在年龄、组织学分级、淋巴结转移、激素受体状态、Ki-67表达水平、Miller-Payne分级等方面的差异有统计学意义(均P<0.05)。458例患者pCR率为40.83%,其中HER-2低表达组的pCR率(17.50%)低于阳性组(59.36%)和阴性组(36.71%),差异有统计学意义(均P<0.05)。Lu-minal型患者中,HER-2低表达组的pCR率低于阴性组(11.40%33.33%,P=0.005);三阴性患者中,HER-2低表达组pCR率与阴性组患者的差异无统计学意义(32.61%vs 38.46%,P=0.546)。NAT前后HER-2状态不一致率为19.27%(42/218),主要是HER-2阴性转变为低表达(10.09%,22/218);Luminal型HER-2不一致率低于三阴性(19.80%vs 26.79%)。结论:HER-2低表达乳腺癌具有一定生物学特性,NAT前后HER-2状态表现出不同程度的变化,非pCR患者HER-2的重新检测可能会为部分患者带来新的治疗机会。
Objective:To investigate the changes in and clinical significance of low expression of human epidermal growth factor receptor-2(HER-2)before and after neoadjuvant therapy(NAT)for breast cancer.Methods:Data were collected from 458 breast cancer patients with NAT to compare and analyze the differences in clinicopathological characteristics and pathological complete response(pCR)rates between different HER-2 status,and the consistency of HER-2 status before and after NAT was tested.Results:There were significant differences between the HER-2 low expression group and the HER-2 negative group in terms of age,histologic grade,lymph node metastasis,hormone receptor status,Ki-67 ex-pression level,and Miller-Payne grade(all P<0.05).The pCR rate was 40.83%in 458 patients,with the pCR rate in the HER-2 low expression group(17.50%)lower than that in the HER-2 positive group(59.36%)and that in the HER-2 negative group(36.71%)(both P<0.05).In Luminal pa-tients,the pCR rate in the HER-2 low expression group was lower than that in the HER-2 negative group(11.40%vs 33.33%,P=0.005);in triple-negative patients,the pCR rate in the HER-2 low expression group was not significantly dif-ferent from that in the HER-2 negative group(32.61%vs 38.46%,P=0.546).The inconsistency rate of HER-2 status be-fore and after NAT was 19.27%(42/218),with a predominant shift from HER-2-negative to low-expression(10.09%,22/218);patients with the Luminal type had a lower rate of HER-2 inconsistency than patients with the triple-negative type(19.80%vs 26.79%).Conclusion:HER-2 low expressing breast cancer has certain biological characteristics.HER-2 sta-tus before and after NAT changes to some extent.The re-detection of HER-2 in non-pCR patients may bring new therapeutic opportunities for some patients.
作者
汪静
夏天
龙鑫
杨青坤
文雪
肖秀丽
Wang Jing;Xia Tian;Long Xin;Yang Qingkun;Wen Xue;Xiao Xiuli(Department of Pathology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China;School of Clinical Medicine,South-west Medical University,Luzhou 646000,Sichuan,China)
出处
《肿瘤预防与治疗》
2024年第3期213-219,共7页
Journal of Cancer Control And Treatment
基金
四川省应用基础研究基金项目(编号:2020YJ4094)。
