HER-2/CEP17信号比与乳腺癌新辅助化疗后病理完全缓解的相关性研究

Correlation between HER-2/CEP17 ratio and pathologic complete response in breast cancer patients receiving neoadjuvant chemotherapy

目的:评价HER-2/CEP17信号比与乳腺癌新辅助化疗后病理完全缓解的相关性及其预测作用。方法:收集中山大学孙逸仙纪念医院2013年1月至2017年12月635例临床分期为ⅡB~Ⅲ期浸润性乳腺癌行新辅助化疗患者的临床资料。根据患者新辅助化疗后手术病理标本,分为病理完全缓解组117例和非病理完全缓解组518例。统计分析HER-2/CEP17信号比是否为全体患者以及联合和非联合靶向治疗亚组病理完全缓解的独立预测因子,并且分析HER-2/CEP17信号比是否与病理完全缓解率具有相关性。结果:635例乳腺癌患者中,总体病理完全缓解率为18.4%(117/635),多因素Logistic回归分析结果显示T分期(OR为0.500,95%CI为0.350~0.712,P<0.001)、Ki-67表达(OR为3.461,95%CI为1.891~6.333,P<0.001)、分子分型(OR为1.458,95%CI为1.188~1.791,P<0.001)、HER-2基因拷贝数(OR为6.173,95%CI为2.110~17.857,P=0.001)及HER-2/CEP17信号比(OR为9.076,95%CI为3.142~26.215,P<0.001)为乳腺癌新辅助化疗获得病理完全缓解的独立预测因子。分析显示HER-2/CEP17信号比也是新辅助化疗联合靶向治疗和非联合靶向治疗亚组的独立预测因子。Spearman秩相关性分析显示HER-2/CEP17信号比与乳腺癌新辅助化疗病理完全缓解率具有相关性(r=0.235,P<0.001)。结论:HER-2/CEP17信号比与乳腺癌新辅助化疗后病理完全缓解具有相关性,是其独立预测因子。

Objective:To investigate the correlation between the HER-2/CEP17 ratio and pathologic complete response(pCR)in invasive breast cancer patients receiving neoadjuvant chemotherapy(NAC).Methods:From January 2013 to December 2017,data of 635 patients with clinical stageⅡB-Ⅲbreast cancer who underwent NAC in Sun Yat-sen Memorial Hospital were reviewed.These patientswere assigned into the pCR group(117 patients)and non-pCR group(518 patients)based on the pathologic specimens.The predictive value of the HER-2/CEP17 ratio for pCR was analyzed in all NAC-receiving patients:NAC with and without trastuzumab groups.Moreover,the correlation between the HER-2/CEP17 ratio and pCR rate was explored.Results:The pCR rate was 18.4%(117/635)in the whole population.According to the multivariate Logistic analysis,clinical tumor staging[odds ratio(OR)=0.500,95%CI:0.350-0.712,P<0.001],Ki-67 expression(OR=3.461,95%CI:1.891-6.333,P<0.001),molecular subtypes(OR=1.458,95%CI:1.188-1.791,P<0.001),HER-2 copy number(OR=6.173,95%CI:2.110-17.857,P=0.001),and the HER-2/CEP17 ratio(OR=9.076,95%CI:3.142-26.215,P<0.001)were independent predictors for pCR.Moreover,the HER-2/CEP17 ratio was an independent predictor for pCR in both the NAC with and without trastuzumab groups.Spearman's rank correlation coefficient analysis suggested that the pCR rate was associated with the HER-2/CEP17 ratio(r=0.235,P<0.001).Conclusions:The HER-2/CEP17 ratio was associated with the pCR in breast cancer patients undergoing NAC and was an independent predictor for pCR.