接受新辅助治疗的 HER-2 低表达乳腺癌患者的临床病理特征

IF 2.5 3区医学 Q3 ONCOLOGY

Oncology Pub Date : 2024-01-01 Epub Date: 2023-09-05 DOI:10.1159/000533787

Shiyuan Zhang, Xiao Yu, Yuting Xiu, Kun Qiao, Cong Jiang, Yuanxi Huang

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引用次数: 0

摘要

导言：人表皮生长因子受体-2（HER-2）低表达乳腺恶性肿瘤已成为近年来的研究热点，但HER-2低表达是否代表乳腺癌的一种特殊亚型尚不清楚。然而，这种分子类型在新辅助治疗阶段需要更有效的治疗方案：本研究纳入了2011年10月至2019年5月期间在哈尔滨医科大学附属肿瘤医院接受新辅助治疗的乳腺癌患者，是一项单中心回顾性研究：这项回顾性研究共纳入1053例接受术前治疗的乳腺癌患者，其中包括279例（26%）HER-2低表达患者。与其他两个分子亚型组相比，HER-2 低表达组 50 岁以下患者的比例更高（P = 0.047，62.0% 对 57.2% 和 52.5%），Ki67 指数高于 15%的患者比例低于 HER-2 阴性和 HER-2 阳性患者（P < 0.001，50.2% 对 63.6% 和 71.5%）。HER-2低表达患者中大部分为激素受体（HR）阳性（p < 0.001，85.7% vs. 60.4% and 36.0%），他们在新辅助治疗后的病理完全缓解率（pCR）明显低于HER-2阴性和HER-2阳性患者（p < 0.001，5.7% vs. 11.8% and 20.5%）。亚组分析结果显示，HER-2低表达的HR阳性患者的pCR率（p <0.001，4.6% vs. 14.6%）和客观反应率（p = 0.001，77.8% vs. 91.0%）低于HER-2阳性患者，与HER-2阴性患者相比无显著差异。在长达67个月（中位随访时间）的总生存期（OS）和无病生存期（DFS）方面，HER-2低、HER-2阴性和HER-2阳性患者之间没有明显差异。Cox危险比例结果显示，Ki67指数和T分期（T3）是DFS的独立影响因素。在OS方面，Ki67指数、P53、T期和客观反应是HER-2低表达患者OS的独立影响因素：总之，HER-2低表达是一种特殊的乳腺癌分子亚型，这一点还需要进一步研究证实。结论：总的来说，HER-2低表达是一种特殊的乳腺癌分子亚型，还需要进一步研究证实，HER-2低表达患者的新辅助治疗疗效相对较差，而新辅助治疗的疗效可以预测HER-2低表达患者的预后。

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Clinicopathological Characteristics of Breast Cancer Patients with HER-2 Low Expression Receiving Neoadjuvant Therapy.

Introduction: Human epidermal growth factor receptor-2 (HER-2) low expression breast malignant tumors have become a research hotspot in recent years, but it is still unclear whether HER-2 low expression represents a special subtype of breast cancer. However, this molecular type requires more effective treatment regimens in the neoadjuvant therapy stage.

Methods: This study enrolled breast cancer patients who were treated at Harbin Medical University Cancer Hospital with neoadjuvant treatment between October 2011 and May 2019 and was a single-center retrospective study.

Results: A total of 1,053 breast cancer patients who received preoperative therapy, including 279 (26%) HER-2 low expression patients, were included in this retrospective study. The HER-2 low expression group had a higher proportion of patients under 50 years old than the other two molecular subtype groups (p = 0.047, 62.0% vs. 57.2% and 52.5%), and the percentage of patients with Ki67 index above 15% was lower than that in HER-2-negative and HER-2-positive patients (p < 0.001, 50.2% vs. 63.6% and 71.5%). Most of the patients with HER-2 low expression were hormone receptor (HR) positive (p < 0.001, 85.7% vs. 60.4% and 36.0%), and their pathologic complete response (pCR) rate after neoadjuvant therapy was significantly lower than that of HER-2-negative and HER-2-positive patients (p < 0.001, 5.7% vs. 11.8% and 20.5%). The results of the subgroup analysis showed HR-positive patients with HER-2 low expression had a lower pCR rate (p < 0.001, 4.6% vs. 14.6%) and objective response rate (p = 0.001, 77.8% vs. 91.0%) than HER-2-positive patients and had no significant difference in these rates compared to HER-2-negative patients. There were no significant differences in overall survival (OS) and disease-free survival (DFS) up to 67 months (the median follow-up time) among HER-2 low, HER-2-negative, and HER-2-positive patients. The results of Cox hazard proportional showed that the Ki67 index and T stage (T3) were independent influencing factors for DFS. In terms of OS, Ki67 index, P53, T stage, and objective response were independent influencing factors for OS in HER-2 low expression patients.

Conclusions: In general, further studies are needed to confirm that HER-2 low expression is a special breast cancer molecular subtype. The efficacy of neoadjuvant therapy in patients with HER-2 low expression is relatively poor, and the efficacy of neoadjuvant therapy can predict the prognosis of patients with HER-2 low expression.

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.