GENISTEIN INHIBITS EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN HER-2/NEU TRANSFECTED HUMAN BREAST CANCER MCF-7 CELLS

Objective： our previous studies have demonstrated that HER-2/neu gene expression in human breast cancer MCF-7 cells promotes angiogenesis in MCF-7 cells xenograft tumors, and genistein inhibits angiogenesis in MCF-7 cells with HER-2/neu expression xenograft tumors. Here, the effects of genistein on the expression of vascular endothelial growth factor （VEGF） in MCR-7 cells with HER-2/neu expression were further studied for exploring the molecular mechanism of anti-angiogenesis in HER-2/neu-overexpressing breast cancer by genistein. Methods： HER-2/neu-overexpressing MCF-7 cells （MCF-7/HER-2） were established by transfecting HEg-2/neu gene into HER-2/neu negative expression breast cancer MCF-7 cells. Immunocytochemical staining, western blot and reverse transcription-polymerase chain reaction （RT-PCR） were adopted to measure the expression of VEGF in MCF-7/HER-2 cells treated by genistein for 24, 48 and 72h. Results： HER-2/neu expression up-regulated VEGF mRNA and protein in MCF-7 cells, genistein decreased VEGF mRNA and protein level in MCF-7/HER-2 cells in a time-dependent manner. Conclusion： These results suggest that VEGF plays an important role in HER-2/neu gene expression promoted antiogenesis in breast cancer and genistein induced down-regulation of the expression of VEGF may be one of the molecular mechanisms of its anti-angiogenesis in HER-2/neu-overexpressing breast cancer.

HER-2 expression after neoadjuvant chemotherapy of the breast cancers

Objective:The aim of this study was to study changes of HER-2 expression after neoadjuvant chemotherapy in the breast cancer cases.Methods:One hundred and thirty-seven female patients with primary breast cancers,who received neoadjuvant chemotherapy,underwent core needle puncture and Mammotome biopsy before chemotherapy,and the biopsy results were used as the basis of histological diagnosis,fluorescence in situ hybridization (FISH) was performed to test HER2 status of tumor tissues before and after chemotherapy.All patients underwent FEC,TE,or AC neoadjuvant chemotherapy of 2-6 cycles before surgery.Results:Twenty-two patients were positive according to FISH test among 137 preoperative patients,8 patients achieved pathological complete remission after chemotherapy (three HER-2 positive patients and five negative patients),91 patients achieved partial remission,24 patients were stable,and 14 cases were invalid.Twenty-two patients were positive according to FISH test (8 patients with pathological complete remission did not undergo test),and positive patients still expressed positively after chemotherapy before neoadjuvant chemotherapy.Three negative patients were converted to be positive,and changes before and after chemotherapy had no statistical difference (P>0.05).Conclusion:Neoadjuvant chemotherapy makes no influence on patients with HER-2 positive expression,while patients with negative expression can be converted to be positive,but without significant difference.

HER-2,P53 and Hormonal Receptors Protein Expression as Predictive Factors in Breast Cancer Prognosis

OBJECTIVE Breast cancer is a heterogeneous disease with vari-able biological and clinical characteristics.We conducted a studyto evaluate P53,HER-2/neu and hormonal receptor expression aspredictors of prognosis in breast cancer.METHODS In a prospective study,we recruited 81 consecutivepatients with primary operable breast cancer who were treatedwith mastectomy followed by locoregional radiotherapy or che-motherapy and studied the presence of P53,HER-2/neu andhormonal receptors (ER/PR) expression in tumor tissues by im-munohistochemical staining.Associations between these markersexpression and clinical outcomes,including local and regionalrecurrence and metastasis were evaluated.Statistical analysis wasperformed with the SPSS software.RESULTS The mean time of follow-up was (47.3±4.6) months.Expression of P53,HER-2/neu,Estrogen receptors and progester-one receptors were observed in 31.1%,38.5%,31.8% and 51.7% ofthe patients,respectively.P53,HER-2/neu and Negative ER statuswere potent predictors of local-regional recurrence (P=0.034,0.038,0.044,respectively).Also HER-2/neu,Negative ER and NegativePR status were strong predictors of metastasis (P=0.001,0.042,0.054,respectively).CONCLUSION P53 and HER-2/neu expression and also steroidreceptors status (ER/PR status) have an important role in predict-ing the outcome of breast cancer and thus may be of value in se-lecting suitable therapeutic strategy and determining prognosis inthese patients.

Relationship between expression of ER, PR, Her-2, Ki-67 and neoadjuvant chemotherapy effect in breast cancer

Objective: The purpose of the study was to investigate the relationship between the expression of estrogen receptor(ER), progestogen receptor(PR), human epidermal growth factor receptor(Her-2), Ki-67 and the effect of neoadjuvant chemotherapy in breast cancer. Methods: The expression of ER, PR, Her-2 and Ki-67 in 45 breast cancers which received neoadjuvant chemotherapy was detected by immunohistochemistry. Results: The effective rates in ER negative and PR negative groups were higher than those in ER positive and PR positive groups(83.3% vs 59. 4%, 82.4% vs 60.6%). There was no significant difference of the effective rate between Her-2 overexpressed group and Her-2 non-overexpressed group(81.8% vs 64.1%), and the same thing happened between Ki-67 negative group and Ki-67 positive group(67.7% vs 63.2%). Conclusion: In the patients with breast cancer, ER, PR negative ones were more sensitive to neoadjuvant chemotherapy. These patients may get more benefits from chemotherapy. ER, PR could be feasible markers for predicting the effective rate of neoadjuvant chemotherapy.

Evaluation of Tobacco Use and Her-2 Receptor Expression in Breast Cancer in an Ethnically Diverse Inner-City Population

Background: Tobacco is linked to most cancers however despite overwhelming biological plausibility and decades of epidemiological studies, no association has been established between tobacco and breast cancer. Although estrogen receptor status has been looked at as a variable there has been no evaluation of the role of Her-2 and smoking in breast cancer. Methods: Review of records from patients treated at the University of Miami/Jackson Memorial Hospital from 1998-2012. The incidence of smoking and Her-2 expression in1255 women was evaluated. Data was analyzed by age, race, ethnic group, menopausal status, tumor stage, and ER/PR/Her-2 receptor status. Results: 1255 charts were analyzed with 1094 having full information. Overall rate of Her-2 expression 18.1%. The rate of Her-2 expression was 21.4% in smokers and 17.0% in non-smokers (p = 0.10). The rate of Her-2 expression was 10.8% in Caucasian smokers and 9.8% in Caucasian non-smokers (p = 0.88);24.5% in smokers of African descent and 17.3% in non-smokers of African descent (p = 0.24);22.9% in Latino smokers and 17.4% in Latino non-smokers (p = 0.10). The rate of Her-2/ER expression was 9.4% in smokers and 7.9% in non-smokers (p = 0.42);5.4% in Caucasian smokers and 4.9% in Caucasian non-smokers (p = 0.916);12.2% in smokers of African descent and 5.9% in non-smokers of African descent (p = 0.11);9.5% in Latin smokers and 8.8% in Latin non-smokers (p = 0.77). Conclusions: We found non-statistically significant positive associations in all analyses between Her-2 expression with or without ER expression and tobacco exposure when analyzed by ethnicity.

Research of vitamin E succinate combined with paclitaxel on the apoptosis of Her-2 over-expressing breast cancer cells

Objective： The aim of this study was to detect apoptosis rates of Her-2 overexpression breast cancer cells, which were administrated with vitamin E succinate （VES） combined with paclitaxel at different dosages, or administrated alone; to discuss the mechanism of their actions. Methods： Using immunohistochemical method to detect Her-2 expression of MDA- MB-453 cells. Using TUNEL assay to detect apoptosis rates of MDA-MB-453 ceils, with the concentrations at 10, 20 mg/L of VES and 50, 100 nmol/L of paclitaxel, and also combined together for 24 or 48 h. Then compared apoptosis action of various combinations. Results： The expression rate of 95% Her-2 was interval （63.32%, 69.60%）; VES and paclitaxel both induced apoptosis of MDA-MB-453 cells, and it is dose to time dependence. It was strongest in apoptosis at 10 mg/L VES and 100 nmol/L paclitaxel in MDA-MB-453 cells 48 h later. Conclusion： VES and paclitaxel both induced apoptosis of MDA-MB-453 cells. It is stronger when the two drugs are administrated together. The mechanism is probably related to reduction of bcl-2 expression, so as to be more sensitive to paclitaxel. Synergistic effect is also possible for the two drugs influence tumor cells in different growing phases.

Quantitative expression of MMP-2 and FN in high metastatic and low metastatic cell lines of breast cancer

To analyze the relation of matrix metalloproteinase-2(MMP-2) and Fibronection (FN) mRNA expression with metastasis of breast cancer and elucidate the role of MMP-2 and FN in breast cancer metastasis.Methods The expression of MMP-2 and FN mRNA in breast cancer cell lines was detected by fluorescence-quantitative RT-PCR.The expression of MMP-2 and FN protein was detected by Western blots.Results The expression of MMP-2 and FN mRNA was down-regulated in high metastatic cell lines MDA-MB-231,MDA-MB-435,but up-regulated in low metastatic cell lines MDA-453,T47D,SK-BR-3 and non-metastatic cell line MCF-7,ZR-75-30.The protein expression of MMP-2 and FN was up-regulated in high mestastic cell lines,and down-regulated in low metastatic cell lines.Conclusion The mRNA and protein expression of MMP-2 and FN was related with breast cancer metastasis.The mRNA expression of MMP-2 and FN is feed-back regulated with protein expression.6 refs,4 figs,2 tabs.

Downregulation of wild-type p53 protein by HER-2/neu mediated PI3K pathway activation in human breast cancer cells: its effect on cell proliferation and implication for therapy

Overexpression and activation of HER-2/neu (also known as c-erbB-2), a proto-oncogene, was found in about 30% of human breast cancers, promoting cancer growth and making cancer cells resistant to chemo- and radio-therapy. Wild-type p53 is crucial in regulating cell growth and apoptosis and is found to be mutated or deleted in 60-70% of human cancers. And some cancers with a wild-type p53 do not have normal p53 function, suggesting that it is implicated in a complex process regulated by many factors. In the present study, we showed that the overexpression of HER-2/neu could decrease the amount of wild-type p53 protein via activating PI3K pathway, as well as inducing MDM2 nuclear translocation in MCF7 human breast cancer cells. Blockage of PI3K pathway with its specific inhibitor LY294002 caused Gl-S phase arrest, decreased cell growth rate and increased chemo- and radio-therapeutic sensitivity in MCF7 cells expressing wild-type p53. However, it did not increase the sensitivity to adriamycin in MDA-MB-453 breast cancer cells containing mutant p53. Our study indicates that blocking PI3K pathway activation mediated by HER-2/neu overexpression may be useful in the treatment of breast tumors with HER-2/neu overexpression and wild-type p53.

CORRELATION BETWEEN SERUM HER-2 ONCOPROTEIN AND PATIENTS WITH BREAST CANCER

To detect serum HER-2 oncoprotein levels in patients with operable and metastatic breast cancers, and to study the correlations between serum HER-2 level and lymph node status as well as other clinical parameters. Methods A total of 120 women were studied consisting of 10 healthy volunteers, 31 benign breast disease, 53 operable breast cancer, and 26 metastatic breast cancer patients. The levels of serum HER-2 were measured using an enzyme-liked im-munosorbent assay (ELISA). Results The mean serum HER-2 levels were 9.6 ± 1.5 ng/mL in healthy volunteers, 11.9 ± 1.6 ng/mL in benign breast disease, 13.2 ± 4.2 ng/mL in operable breast cancer, and 30.5 ± 30.8 ng/mL in metastatic breast cancer patients. The former is much lower than the latter three (P = 0.02, 0.001, 0.03, respectively). If using 15 ng/mL as a normal baseline, elevated serum HER-2 levels were observed in none of the healthy volunteers as well as patients with benign disease, but in 18.9% (10/53) operable breast cancer patients and 61.5% (16/26) metastatic patients. In patients with operable breast cancer, there was a positive correlation between serum concentrations of HER-2 and the size of primary tumor (P < 0.05), whereas there was no correlation between serum concentration and axillary lymph node or estrogen receptor status. In patients with metastatic dise-ase, there was no correlation with site of metastases (P > 0.05). Conclusion Serum HER-2 level was strongly correlated with tumor loads and clinical stages, thus acting as a promising predictor of cancer recurrence in breast cancer patients.

Comparison of Fluorescence in situ Hybridization and Immunohistochemistry for Assessment of HER-2 Status in Breast Cancer Patients

The accurate assessment ofa proto-oncogene, human epidermal growth factor receptor-2 gene （HER-2）, is extremely important for the therapy and prognosis of breast cancer. Currently, immunohistochemistry （IHC） is the method widely used for the detection of HER-2 protein. Fluorescence in situ hybridization （FISH） has been suggested to be a golden standard assay for HER-2 amplification. This study examined the expression and amplification of HER-2 in paraffin-embedded sections of breast cancer tissues, and compared the two methods on the measurement of HER-2 status. HER-2 gene and protein were determined in breast cancer samples from 52 Chinese women by FISH and IHC respectively. The findings indicated that the HER-2 gene amplification was found in 18 cases （34.6%） by FISH and the HER-2 protein over-expression （score 3＋） in 15 cases （28.8%） by IHC. hnmunohistochemically, 28.6% of the cases scored as 2＋ and 93.3% of the cases scored as 3＋ were HER-2-positive by FISH. There was a significant correlation between the HER-2 gene amplification and HER-2 protein over-expression in breast cancer （P〈0.005）. No correlation was noted between the HER-2 gene amplification and any of the clinicopathological parameters examined, including age, menopausal status, menarche age, tumor size, histological tumor type, histological grade, lymph node status, and the expression of ER and PR. It was concluded that the detection of HER-2 gene amplification in breast cancer by FISH is valuable and can compare with HER-2 protein detection by IHC.

Impressive Objective Response to Nab-Paclitaxel plus Trastuzumab as Fifth Line Therapy in an Elderly HER-2 Positive Breast Cancer Patient

Background: Agent targeting HER-2 pathway plus chemotherapy has represented a major progress in the management of patients with breast cancer. However, the role of late-line treatment in heavily pretreated patients is still largely unclear. In the last decade, nab-paclitaxel has shown significant activity and good toxicity profile in metastatic breast cancer. Case Presentation: We report the case of a 76-year-old Caucasian woman with metastatic HER-2 positive ductal infiltrating breast carcinoma treated with a combination of weekly nab-paclitaxel and trastuzumab as fifth-line therapy. She had previously received first-line paclitaxel and trastuzumab, second-line vinorelbine and trastuzumab, third-line TDM1 and fourth-line oral capecitabine and lapatinib. Clinical and radiological staging showed progression at bone, skin and soft-tissue. The patient received weekly nab-paclitaxel plus trastuzumab. Massive objective response was clinically and PET documented which lasted 8 months. Tolerance to treatment was fairly good as well as cardiac safety. Conclusion: To the best of our knowledge, this is the first reported case of efficacy of nab-paclitaxel in combination with trastuzumab as fifth-line of treatment in a patient with metastatic HER-2 positive breast cancer.

Detection of HER-2/neu Amplification on Fine Needle Aspirates of Breast Cancer Using Fluorescence in Situ Hybridization

The accuracy of diagnostic assays for HER-2/neu in breast cancer is extremely important as HER-2/neu status is essential in tailoring adjuvant and/or neoadjuvant treatment in every patient. FNAC is widely practiced in Egypt in preoperative diagnosis of breast cancer for its low cost and high diagnostic accuracy. Since the determination of HER-2/neu protein expression on cytological preparations was previously found to be unreliable for clinical use, we opted for the assessment of HER-2/neu status in fine needle aspirates using FISH. The main objective of this study was to evaluate the reliability of HER-2/neu status assessment by FISH on fine needle aspirates of breast cancers by comparing the results with IHC and FISH on FFPE tissue sections obtained from corresponding surgically resected specimens. Fine needle aspirates from 40 breast cancer patients with pathologically confirmed breast cancer were included in the study. They were submitted for HER-2/neu evaluation by FISH. After surgery, the corresponding FFPE sections were evaluated for HER-2/neu by FISH and by IHC. FNAs from 11 cases proved to be amplified by FISH, while 29 cases were not amplified. Apart from two cases that showed lack of signals, all specimens evaluated by FISH on the corresponding FFPE sections showed matched results. The Measurement of Agreement between FISH on FNAs and FISH on FFPE sections was 86.7%, while that between FISH on FNAs and IHC was 72.5%. The high concordance rate in the present study between FISH evaluation of HER-2/neu gene amplification on FNAC samples and their corresponding FFPE samples indicate that FISH may be a reliable technique for HER-2/neu assessment on FNAs. Furthermore, FISH on FNAs gave us better hybridization signals than their corresponding FFPE tissue sections. Finally, we also conclude that all score (2+) cases by IHC should be reevaluated by FISH which is crucial for the patient management.

德曲妥珠单抗对比化疗方案二线治疗HER-2低表达晚期乳腺癌的经济学评价

目的 从我国卫生体系角度出发,评价德曲妥珠单抗方案对比医生选择化疗(TPC)方案二线治疗人表皮生长因子受体2(HER-2)低表达晚期乳腺癌的经济性。方法 基于DESTINY-Breast04临床试验数据构建动态Markov模型,模拟时限为10年,循环周期为3周。以成本、质量调整生命年(QALY)、增量成本-效果比(ICER)作为模型产出指标,采用5%的贴现率,以3倍2023年我国人均国内生产总值(GDP)作为意愿支付(WTP)阈值,采用成本-效用分析法分析激素受体阳性队列和所有患者队列中两种治疗方案的经济性,再通过不确定性分析验证基础分析结果的稳健性。结果 基础分析结果显示,德曲妥珠单抗方案与TPC方案相比,在激素受体阳性队列和所有患者队列中的ICER值分别为1 045 655.76、906 404.99元/QALY,均高于WTP阈值(268 074元/QALY)。单因素敏感性分析结果显示,疾病无进展状态效用值、德曲妥珠单抗价格、疾病进展状态效用值等参数对模型结果影响较大。概率敏感性分析结果显示,当WTP阈值为3倍2023年我国人均GDP时,德曲妥珠单抗方案具有经济性的概率为0。情境分析结果显示,在考虑援助计划时,德曲妥珠单抗方案具有经济性的概率为0;当德曲妥珠单抗价格降低70%时,该方案具有经济性的概率显著提高至82.80%。结论 在以3倍2023年我国人均GDP作为WTP阈值时,德曲妥珠单抗方案相对于TPC方案二线治疗HER-2低表达晚期乳腺癌不具有经济性;按地区适当降低德曲妥珠单抗的价格,可以提高其经济性。

HER-2低表达与HER-2阴性早期乳腺癌临床与病理特征及NACT效果对比

目的 探讨人表皮生长因子受体-2(HER-2)低表达与HER-2阴性早期乳腺癌临床与病理特征及新辅助化疗(NACT)效果的差异性。方法 收集2018年1月—2022年7月于我院行NACT及手术治疗的137例早期乳腺癌患者的临床资料行回顾性分析,根据化疗前HER-2状态分为HER-2低表达组(HER2-low组,n=94)和HER-2阴性组(HER2-zero组,n=43),并进一步依据激素受体状态(HR+/-)分为HR+/HER2-low组(n=74)、HR+/HER2-zero组(n=28)、HR-/HER2-low组(n=20)、HR-/HER2-zero组(n=15)四个亚组;对比分析两组及亚组间的年龄、BMI、月经状态、分子亚型、组织学分级,TNM分期、化疗方案和周期、手术方式,NACT前后雌孕激素受体和Ki-67状态,NACT后靶病灶客观缓解率和腋窝淋巴结缩小比例,术后腋窝淋巴结病理状态和病理M&P分级,组间及亚组间pCR率等。结果 HER2-low组患病率显著高于HER2-zero组(P<0.05);HER2-low组与HER2-zero组一般资料差异无统计学意义(P>0.05);HER2-low组雌激素受体阳性率和Ki-67<35%的比例显著高于HER2-zero组,而在靶病灶客观缓解率(ORR)和HR-亚组中的pCR率显著降低,同时对比发现HR-/HER2-low亚组具有较高的组织学分级和较低的Ki-67<35%状态,差异均有统计学意义(P<0.05);HER2-low组与HER2-zero组在腋窝淋巴结缩小比例、术后腋窝淋巴结病理状态及组间pCR率等其他预后指标方面差异无统计学意义(P>0.05)。结论 HER-2低表达较HER-2阴性早期乳腺癌患病率高,且具有较高的雌激素受体阳性率和较低的Ki-67状态,缩瘤效果较差,并在激素受体阴性亚组中的pCR率显著降低,同时发现低pCR率与较高的组织学等级和较低的Ki-67状态相关。

HER-2低表达患者在乳腺癌中的占比及其临床病理特征

目的:研究HER-2低表达患者在乳腺癌中的占比及其临床病理特征。方法:收集2019年1月—2023年12月间深圳市妇幼保健院收治的982例浸润性乳腺癌患者的癌组织样本,采用免疫组织化学(IHC)法检测癌组织中人类表皮生长因子受体2(HER-2)、雌激素受体(ER)、孕激素受体(PR)以及细胞增殖相关蛋白Ki-67的表达情况,荧光原位杂交(FISH)法检测HER-2基因扩增情况,此外对其他临床病理资料如患者年龄、肿瘤直径、组织学分级、淋巴结转移等进行回顾性研究,分析HER-2低表达患者在乳腺癌中的占比及其与HER-2阴性、HER-2阳性乳腺癌患者间的临床病理特征差异。结果:982例乳腺癌中HER-2低表达567例(57.74%),HER-2阴性194例(19.76%),HER-2阳性221例(22.50%)。HER-2低表达乳腺癌的组织学分级和Ki-67增殖指数均低于HER-2阴性和HER-2阳性乳腺癌(均为P<0.01);淋巴结转移率高于HER-2阴性乳腺癌,但低于HER-2阳性乳腺癌(均为P<0.01);激素受体阳性率高于HER-2阳性乳腺癌(P<0.01),与HER-2阴性乳腺癌的差异无统计学意义(P>0.05)。此外,HER-2低表达乳腺癌患者年龄及肿瘤直径与HER-2阴性和HER-2阳性乳腺癌比较差异均无统计学意义(P>0.05)。结论:HER-2低表达乳腺癌在整体乳腺癌中占比高,且具有组织学分级低、Ki-67增殖指数低、激素受体阳性率高等特点,临床工作中应予以重视。

Her-2低表达乳腺癌临床病理特征及生存状况分析

目的分析人表皮生长因子受体-2(human epidermal growth factor receptor-2,Her-2)低表达与Her-2阴性乳腺癌的临床病理特征及生存状况。方法回顾性收集2013年4月~2022年11月就诊于新疆医科大学第一附属医院的327例定义为Her-2阴性或低表达乳腺癌患者的临床病理和预后生存资料,依据Her-2状态分为Her-2低表达组(n=217)和Her-2阴性组(n=110)。比较两组患者的临床病理特征、治疗后复发转移情况、病死率、总生存期和无疾病进展生存期等,并依据激素受体(hormone receptor,HR)状态分为HR+和HR-队列,比较两种队列下Her-2阴性或低表达乳腺癌患者的无疾病进展生存期。结果Her-2低表达乳腺癌临床中占比高,多合并雌激素受体(estrogen receptor,ER)阳性,表现为Luminal型,病理预后分期多为Ⅰ期,且ki-67低表达;而Her-2阴性乳腺癌多合并ER阴性,表现为三阴性型,病理预后分期多为Ⅲ期,ki-67高表达,并在治疗后出现更多的脑转移和(或)其他脏器转移,差异有统计学意义(P<0.05)。但两组患者在病死率、总生存期、组间及两种队列间无疾病进展生存期方面比较,差异无统计学意义(P>0.05)。结论Her-2低表达与Her-2阴性乳腺癌之间存在肿瘤异质性,Her-2低表达乳腺癌具有ER阳性率高,ki-67低表达,病理预后分期较早等优势,且治疗后脑转移和(或)其他脏器转移率较低,但尚未转换为显著的生存获益。

三阴性乳腺癌中HER-2低表达与HER-2不表达的新辅助化疗疗效评估

目的 探讨三阴性乳腺癌(triple negative breast cancer, TNBC)患者中HER-2低表达和HER-2不表达在新辅助化疗(neoadjuvant chemotherapy, NAC)疗效方面的差异。方法 回顾性收集2018年1月~2020年1月就诊于南阳市中心医院的120例TNBC患者的临床病理资料,初诊行NAC治疗,其中HER-2低表达组57例,HER-2不表达组63例。采用双侧χ^(2)检验分析比较两组患者的临床病理特征。3年术后复发率或转移率。二元Logistic回归分析评价临床病理因素对病理完全缓解(pathological complete response, pCR)的影响。采用生存曲线比较两组患者的无病生存率。结果 相较于HER-2不表达组,HER-2低表达组患者T_(3~4)期的患者比例显著增高(P<0.05),腋窝淋巴结有转移的患者比例也显著增高(P<0.05),而组织学分级显著更低(P<0.05)。腋窝淋巴结状态(P<0.05)和HER-2表达水平(P<0.05)是TNBC患者pCR的独立影响因素,腋窝淋巴结有转移和HER-2低表达的TNBC患者,在NAC治疗后更不容易达到pCR状态,另外,HER-2低表达组相较HER-2不表达组,3年复发率或转移率明显升高(28.1%vs 11.1%,P<0.05),无病生存率显著降低(P<0.05)。结论 在TNBC患者中,相较于HER-2不表达,HER-2低表达患者腋窝淋巴结转移率更高,在NAC后更不容易达到pCR,预后结果也更差。

HER-2低表达乳腺癌患者的临床病理特征分析

目的:探讨HER-2低表达乳腺癌患者的临床病理特征,为其独立分型及精准治疗提供临床病理数据支持。方法:收集非特殊型浸润性乳腺癌患者的临床病理资料,把HER-2阴性患者分为HER-2不表达[免疫组化结果HER-2(0)]和HER-2低表达[免疫组化结果HER-2 (1+),或HER-2(2+)且原位杂交结果无扩增(ISH-)]两组对比研究。结果:HER-2低表达乳腺癌患者淋巴结转移率高于HER-2不表达患者(P<0.05),Spearman秩相关分析显示HER-2表达量与淋巴结转移率成正相关(rs=0.210,P<0.05)。结论:HER-2低表达有着不同于HER-2不表达的临床病理特征,其有望独立成为新的分子分型,对其深入研究,有利于改变HER-2低表达乳腺癌患者治疗模式,为其提供更精准的治疗。

HER-2低表达的三阴性乳腺癌患者的临床特征及预后研究

目的分析HER-2低表达的三阴性乳腺癌患者的临床特征及预后。方法选取2020年10月—2022年12月本院收治的三阴性乳腺癌患者108例为研究对象,根据HER-2低表达不同将患者分为阴性组和低表达组,比较两组患者的临床特征、术后复发率、转移率及术后生存率。结果低表达组患者的Ki-67、T3分期、淋巴结转移的发生率、腋窝淋巴结清扫率显著增高,术后3年复发率或转移率显著增高(P<0.05);HER-2低表达、淋巴结转移、T分期为T3是直接造成患者术后3年疾病再次发生的危险因素(P<0.05);低表达组患者的无病生存率显著低于阴性组(P<0.05)。结论HER-2低表达的三阴性乳腺癌患者的临床征象与常规患者之间存在一定的差异,HER-2低表达、淋巴结转移、T3分期是直接造成患者术后3年疾病再次发生的危险因素,对患者的术后生存率有显著影响。

Chidamide Combined with Paclitaxel Liposome for the Treatment of Advanced HER2-negative Breast Cancer in Clinical Study

The purpose of this study was to investigate the efficacy and safety of chidamide combined with paclitaxel liposome in the treatment of advanced HER-2-negative breast cancer.First,41 patients with advanced HER-2-negative breast cancer who had received two chemotherapy regimens from May 2017 to November 2017 were randomly selected to receive chidamide combined with paclitaxel liposome treatment(observation group,n=20)or placebo combined with paclitaxel liposome treatment(control group,n=21).The treatment scheme of the observation group was oral chidamide 30mg twice a week for 2 months.In addition,on day 1,the patients were given paclitaxel liposome orally and intravenously administered with 175 mg/m2 for 1 cycle for 21 days and 3 cycles of chemotherapy.The treatment scheme of the control group was oral placebo 30 mg twice a week for 2 months.In addition,the method of paclitaxel liposome administration was the same as the observation group.The response rate(RR),disease control rate(DCR),and progression-free survival(PFS)were compared between the two groups.The results showed that all the 41 patients could be evaluated.In the observation group,CR5,PR7,SD5 and PD3 were obtained.RR was 60.0%and DCR was 85.0%.In the control group,CR3,PR3,SD5 and PD10 were obtained.RR was 28.6%and DCR was 52.4%.RR and DCR in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).The median PFS of the observation group was 5.2 months,longer than that of the control group(3.1 months,P<0.05).The main adverse reactions in the two groups were gastrointestinal reactions and bone marrow suppression,with grade 1~2 as the main ones.The incidence of leukopenia,thrombocytopenia and nausea and vomiting in the observation group was higher than that in the control group(P<0.05).Therefore,the chidamide combined with paclitaxel liposome is effective in the treatment of advanced HER-2-negative breast cancer,and the adverse reactions can be tolerated.