HER-2低表达乳腺癌的临床病理特征及预后分析

Pathological features and prognosis of breast neoplams with low expression of HER-2

目的探究人表皮生长因子受体-2(HER-2)低表达乳腺癌的临床病理特征,分析HER-2低表达对乳腺癌预后的影响。方法单中心临床研究。抽取2015年6月至2018年12月在河南科技大学附属许昌市中心医院接受抗肿瘤治疗的乳腺癌患者114例作为研究对象,依据HER-2表达强度分为HER-2低表达组76例和HER-2零表达组38例。回顾性分析两组患者的临床病理资料和随访资料,采用Kaplan-Meier法绘制无病生存(DFS)曲线和总生存(OS)曲线,比较两组患者的3年和5年DFS率和OS率。结果HER-2低表达组患者的雌激素受体(ER)阳性率、激素受体(HR)阳性率、Ki-67<30%占比、腋窝淋巴结转移率、组织分化类型中低分化占比均高于HER-2零表达组(P均<0.05)。两组患者的年龄、体质指数、月经状态、肿瘤家族史、病理类型、T分期、TNM分期比较,差异未见统计学意义(P>0.05)。HER-2低表达组和HER-2零表达组的3年DFS率分别为84.21%(64/76)和92.11%(35/38),3年OS率分别为92.11%(70/76)和97.37%(37/38);5年DFS率分别为63.16%(48/76)和81.58%(31/38),5年OS率分别为80.26%(61/76)和92.11%(35/38)。HER-2低表达组患者5年DFS率低于HER-2零表达组(P<0.05);两组患者的3年DFS率、3年OS率及5年OS率比较,差异未见统计学意义(P>0.05)。结论HER-2低表达乳腺癌的ER阳性率高,Ki-67表达率低,腋窝淋巴结转移率高,5年DFS率低,这些临床病理特征为HER-2低表达乳腺癌患者的个体化、精准化治疗提供了新思路。

Objective To investigate the clinicopathologic features of breast neoplams with low expression of human epidermal growth factor receptor 2(HER-2),and to analyze the influence of low-expression HER-2 on the prognosis of breast neoplams.Methods A total of 114 cases of breast neoplams who received anti-tumor therapy in Xuchang Central Hospital Affiliated to Henan University of Science and Technology from June 2015 to December 2018 were enrolled in the single center clinical study.According to the intensity of HER-2 expression,the selected patients were divided into the HER-2 low expression group(76 cases)and the HER-2 zero expression group(38 cases).The clinicopathologic data and follow-up data of the two groups were analyzed retrospectively.The disease-free survival(DFS)and overall survival(OS)curves were drawn by Kaplan-Meier method,and the rate of 3-and 5-year DFS and OS of the two groups were compared.Results The positive rate of estrogen receptor(ER),positive rate of hormone receptor(HR),proportion of Ki-67<30%,axillary lymph node metastasis rate,proportion of low-differentiation tissue of the HER-2 low-expression group were higher than those of the HER-2 zero expression group(all P<0.05).There was no significant difference in age,body mass index,menstrual status,family history of tumor,pathological type,T stage and tumor-node-metastasis stage between the two groups(P>0.05).The 3-year DFS rate of the HER-2 low-expression group and the HER-2 zero-expression group were 84.21%(64/76)and 92.11%(35/38),respectively,while the 3-year OS rate of the two groups were 92.11%(70/76)and 97.37%(37/38),respectively.The 5-year DFS rate of the HER-2 low-expression group and the HER-2-zero expression group were 63.16%(48/76)and 81.58%(31/38),respectively;while the 5-year OS rate of the two groups were 80.26%(61/76)and 92.11%(35/38),respectively.The 5-year DFS rate of the HER-2 low-expression group was lower than that of the HER-2 zero-expression group(P<0.05).There was no significant difference in the 3-year DFS rate,3-year OS rate,or 5-year OS rate between the two groups(P>0.05).Conclusions HER-2 low-expression breast neoplams have a high positive rate of ER,low rate of Ki-67 expression,high rate of axillary lymph node metastasis,and low 5-year DFS rate.These clinicopathological features provide a new idea for individualized and precise treatment of breast neoplams with low-expression of HER-2.