HER2低表达和HER2阴性表达乳腺癌患者临床、病理特征及预后

Clinical and pathological features and prognosis of breast cancer patients with HER2low expression and HER2negative expression

目的分析人表皮生长因子受体2(HER2)低表达和HER2阴性表达乳腺癌患者临床、病理特征及预后。方法行手术切除的非HER2过表达型乳腺癌患者257例中,管腔A型82例,管腔B型118例,三阴性57例。分析非HER2过表达型乳腺癌患者中HER2低表达和HER2阴性表达患者的临床、病理特征及预后。分析管腔A、B型乳腺癌患者和三阴性乳腺癌患者中HER2低表达和HER2阴性表达患者的临床、病理特征及预后。结果非HER2过表达型乳腺癌患者中,HER2低表达和HER2阴性表达不同年龄、绝经状态、组织学分级、肿瘤浸润淋巴细胞(TILs)百分比、程序性死亡配体1(PD-L1)表达及Ki-67表达的患者比例差异均有统计学意义(P<0.05或P<0.01)。管腔A、B型乳腺癌患者中,HER2低表达和HER2阴性表达患者不同年龄、绝经状态、TILs百分比、PD-L1表达及Ki-67表达的患者比例差异亦有统计学意义(P<0.05或P<0.01)。三阴性乳腺癌患者中,HER2低表达和HER2阴性表达患者不同组织学分级、TILs百分比、PD-L1表达及Ki-67表达的患者比例差异均有统计学意义(P<0.05或P<0.01)。非HER2过表达型乳腺癌和管腔A、B型乳腺癌患者中,HER2低表达和HER2阴性表达患者总生存期(OS)率和无病生存期(DFS)率相仿(P>0.05)。三阴性乳腺癌患者中,HER2低表达OS率和DFS率均高于HER2阴性表达(P<0.05)。结论HER2低表达和HER2阴性表达乳腺癌患者具有不同的临床、病理特征及预后,临床应根据不同的HER2状态制定相应的治疗策略。

Objective To analyze the clinical and pathological features and prognosis of breast cancer patients with human epidermal growth factor receptor 2(HER2)low expression and HER2 negative expression.Methods A total of 257breast cancer patients without HER2-overexpression underwent surgical resection,of whom 82cases were with luminal type A breast cancer,118cases were with luminal type B breast cancer,and 57cases were with triple-negative type breast cancer.The clinical and pathological features and prognosis of HER2low expression and HER2 negative expression in the patients with non HER2-overexpression,luminal A and B type breast cancer,and triple-negative type breast cancer were analyzed.Results There were significant differences in the proportion of patients of different age,menopausal status,histological grade,percentage of tumor infiltrating lymphocytes(TILs),expressions of programmed death ligand 1(PD-L1)and Ki-67 between the patients with HER2low expression and those with HER2negative expression in breast cancer patients without HER2-overexpression(P<0.05 or P<0.01).There were significant differences in the proportion of patients of different age,menopausal status,TILs percentage,PD-L1 expression and Ki-67expression between the patients with HER2low expression and HER2negative expression in breast cancer patients with luminal A and B type breast cancer(P<0.05or P<0.01).There were significant differences in the proportion of patients of different histological grade,TILs percentage,PD-L1expression and Ki-67expression between the patients with HER2low expression and those with HER2negative expression in breast cancer patients with triple-negative type breast cancer(P<0.05or P<0.01).The rates of overall survival(OS)and disease-free survival(DFS)of the patients with HER2low expression and those with HER2negative expression in breast cancer patients without HER2-overexpression,or with luminal A and B type were similar(P>0.05).The rates of OS and DFS of the patients with HER2low expression were higher than those with HER2 negative expression in breast cancer patients with triple-negative type(P<0.05).Conclusion Breast cancer patients with HER2low expression and HER2negative expression have different clinical and pathological features and prognosis,and different clinical treatment strategies should be taken according to different HER2status.