HER-2预测术后ER阴性乳腺癌患者长期生存的探讨

Detection of HER-2 predicts long-term survival in breast cancer patients with negative estrogen receptor

目的分析HER-2和ER表达对术后乳腺癌患者长期生存时间的预测作用。方法收集143例经长期随访(>5年)的乳腺癌患者的组织标本,并通过免疫组化进行HER-2、ER检测,统计学分析这些指标与患者生存时间的关系。结果在143例具有完整治疗的乳腺癌患者中,Cox回归分析发现,ER和HER-2的表达状态明显与患者的预后有关。以ER表达作为分类变量,发现在ER阴性组,HER-2阳性患者的生存时间明显短于阴性患者。在生存曲线上,HER-2阴性患者生存80个月的可能性大于阳性患者。在ER阳性组,虽然HER-2阳性患者的生存时间与阴性患者存在差异,但无统计学意义。结论HER-2是预测术后ER阴性乳腺癌患者长期生存时间的理想生物学标记。

Aim To evaluate the predictive role of HER-2 for long-term survival in estrogen receptor （ER） negative patients with breast cancer. Methods The tissue samples from 143 breast cancer patients with a long-term follow-up （more than 5 years） were collected, and then HER-2 and ER were detected by an immunohistochemical method. The relationship between HER-2 and ER expression and prognosis was assessed. Results Through a Cox regression model, HER-2 and ER expression in 143 patients was associated with relapse-free survival. ER was considered as a dicholomous variable. In ER negative group, patients without HER-2 over-expression had a longer survival time than patients with HER-2 over-expreasion. [ 101.0 months （95%C1 93.6 - 108.4） vs 91.0 months （95% Cl 84.3 - 97.7） （ P = 0.005） ]. In Kaplan-Meier analysis, patients with HER-2 negative expression had more possibility of long - term survival （more than 80 months）, compared with HER-2-positive patients. There was no significant difference between patients with HER-2 over-expression and ones with negative HER-2 in ER positive group. Conclusion HER-2 is a perfect prognostic marker for long-term survival breast cancer patients with negative ER.