皖南地区乳腺癌HER-2表达构成比分析

Pathological analysis of HER-2 expression in breast cancer in southern Anhui

目的 探讨皖南地区乳腺癌人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达状况构成比分析,以期为临床HER2靶向治疗提供参考。方法 收集皖南医学院弋矶山医院2020-01至2023-07间明确诊断的乳腺癌标本,经苏木素-伊红染色、免疫组织化学染色,参照《乳腺癌HER2检测指南(2014版)》、Scarff-Bloom-Richardson(ESBR)分级系统、2019年(第5版乳腺肿瘤WHO分类)进行诊断病理分类、分型,并进行分析。结果 本地区乳腺癌HER2表达状况:HER2(阴性)108例(76.6%),HER2(阳性)33例(23.4%)。病理组织学类型为导管型74例(52.5%),其次小叶型64例(45.4%),特殊类型3例(2.1%)。组织学分级Ⅱ级57例(40.2%),其次为Ⅲ级45例(31.9%),Ⅰ级39例(27.7%)。肿块右侧乳房为75例(53.2%),左侧乳房66例(46.8%)。141例中,年龄最大者78岁,最小者27岁,平均年龄(54.45±9.79)。通过单因素分析HER2表达是否阳性按年龄、绝经状况、肿块部位、组织病理类型、组织学分级、PR表达(阳性/阴性)构成差异均无统计学意义(P>0.05),HER2表达不同类型按ER表达(阳性/阴性)、Ki-67增殖指数、不同地区报道之间有统计学意义(P<0.05),多因素分析因变量肿块部位、ER表达状况、Ki-67增殖指数对HER2表达是否阳性不具有统计学差异(P>0.05)。结论 ER表达状况对浸润性乳腺癌HER2表达状况是否阳性产生负面影响,而肿块部位和Ki-67增殖指数对其产生正面影响。

Objective To analyze the expression status of human epidermal growth factor receptor 2(HER-2)in breast cancer in the southern Anhui region,so as to provide a reference for clinical HER2-targeted therapy.Methods Breast cancer specimens diagnosed at the Yijishan Hospital of Wannan Medical College from January 2020 to July 2023 were collected.Hematoxylin-eosin staining,immunohistochemical staining,and pathological classification and grading were performed according to the Breast Cancer HER-2 Testing Guidelines(2014 edition),the Scarff-Bloom-Richardson(ESBR)grading system,and the 2019(5th edition)WHO classification of breast tumors.Results In this region,the expression status of HER-2 in breast cancer were 108 HER-2 negative cases(76.6%)and 33 HER-2 positive cases(23.4%),respectively.The pathological histological types were ductal type 74 cases(52.5%),lobular type 64 cases(45.4%),and special types 3 cases(2.1%).The histological grades were grade II 57 cases(40.2%),grade III 45 cases(31.9%),and grade I 39 cases(27.7%).The tumors located in the right breast were 75 cases(53.2%)and the left were 66 cases(46.8%).The ages ranged from 27 to 78 years,with an average age of(54.45±9.79)years.Univariate analysis showed no statistically significant differences in HER-2 positivity by age,menopausal status,tumor location,histological type,histological grade,or PR expression(P>0.05).However,there were statistically significant differences in HER-2 expression by ER expression,Ki-67 proliferation index,and different regional reports(P<0.05).Multivariate analysis showed no statistically significant differences in tumor location,ER expression,and Ki-67 proliferation index on HER-2 positivity(P>0.05).Conclusion ER expression status has a negative impact on the positivity of HER-2 expression in invasive breast cancer,while tumor location and Ki-67 proliferation index have a positive impact.