早期乳腺肿瘤患者her2 -低水平的临床病理特征及预后意义her2 -低水平与her2 -阴性乳腺癌激素受体分层预后比较

Sanaa Gamrani, Laila Akhouayri, Sara Boukansa, Mehdi Karkouri, Hinde El Fatemi
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In this study, we aimed to evaluate the clinicopathological characteristics and prognostic impact of this particular subtype in a North-African context where HER2-low breast cancer is a relatively understudied subtype, particularly in non-Western populations. <i>Methods</i>. We conducted a retrospective cohort study on 1955 breast tumors in Moroccan patients over 10 years, collected at the Pathology Department of Ibn Rochd University Hospital in Casablanca and at the pathology department of Hassan II University Hospital in Fes. We elaborated on their complete immunohistochemical profile based on the main breast cancer biomarkers: Ki-67, HER2, estrogen, and progesterone receptors. Their overall survival and disease free survival data were also retrieved from their respective records. <i>Results</i>. Out of 1955 BC patients, 49.3% were classified as HER2-low; of which 80.7% and 19.2% were hormone receptors positive and negative, respectively. The clinicopathologic features indicate that HER2-low subtype tumors behave much more like HER2-positive than HER2-negative tumors. The survival analysis showed that the HER2-low subtype-belonging patients present significantly the poorest prognosis in disease-free survival (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"></path></g></svg>)</span></span> in comparison with HER2-negative ones. When considering the hormonal status, hormonal-dependent tumors show a significant difference according to HER2 subtypes in disease-free survival (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"></path></g></svg>).</span></span> Yet no significant difference was shown among hormonal negative tumors. Moreover, patients with hormonal positive tumors and simultaneously belonging to the HER2-low subgroup present a significantly good prognosis in overall survival compared to the ones with hormonal negative tumors (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"></path></g></svg>).</span></span> <i>Conclusion</i>. Our study has shown that the HER2-low phenotype is common among hormone-positive patients. The clinicopathological features and prognostic data indicate that the hormonal receptors effect and HER2 heterogeneity are crucial factors to consider. It is important to note that this particular subgroup is different from the HER2-negative one and should not be treated in the same way. Therefore, this study offers a new perspective in the management of HER2-low patients and can serve as a basis for future prospective analyses.","PeriodicalId":501151,"journal":{"name":"The Breast Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Clinicopathological Features and Prognostic Significance of HER2-Low in Early Breast Tumors Patients Prognostic Comparison of HER-Low and HER2-Negative Breast Cancer Stratified by Hormone Receptor Status\",\"authors\":\"Sanaa Gamrani, Laila Akhouayri, Sara Boukansa, Mehdi Karkouri, Hinde El Fatemi\",\"doi\":\"10.1155/2023/6621409\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Introduction</i>. There has been increased interest in HER2-low breast tumors recently, as these tumors may have distinct clinical and molecular characteristics compared to HER2-negative and HER2-positive tumors. A new nomenclature has been proposed for HER2 1+ and HER2 2+ tumors that are confirmed negative according to fluorescence in situ hybridization (FISH). These tumors are now referred to as HER2-low, and it is thought that they may represent a distinct subtype of breast cancer that warrants further investigation. In this study, we aimed to evaluate the clinicopathological characteristics and prognostic impact of this particular subtype in a North-African context where HER2-low breast cancer is a relatively understudied subtype, particularly in non-Western populations. <i>Methods</i>. We conducted a retrospective cohort study on 1955 breast tumors in Moroccan patients over 10 years, collected at the Pathology Department of Ibn Rochd University Hospital in Casablanca and at the pathology department of Hassan II University Hospital in Fes. We elaborated on their complete immunohistochemical profile based on the main breast cancer biomarkers: Ki-67, HER2, estrogen, and progesterone receptors. Their overall survival and disease free survival data were also retrieved from their respective records. <i>Results</i>. Out of 1955 BC patients, 49.3% were classified as HER2-low; of which 80.7% and 19.2% were hormone receptors positive and negative, respectively. The clinicopathologic features indicate that HER2-low subtype tumors behave much more like HER2-positive than HER2-negative tumors. 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When considering the hormonal status, hormonal-dependent tumors show a significant difference according to HER2 subtypes in disease-free survival (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-113\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"></path></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 28.184 11.7782\\\" width=\\\"28.184pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.289,0)\\\"></path></g></svg>).</span></span> Yet no significant difference was shown among hormonal negative tumors. 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引用次数: 0

摘要

介绍。由于与her2阴性和her2阳性肿瘤相比,这些肿瘤可能具有不同的临床和分子特征,最近人们对her2低乳腺癌的兴趣越来越大。根据荧光原位杂交(FISH)证实为阴性的HER2 +和HER2 +肿瘤提出了一个新的命名法。这些肿瘤现在被称为her2低,人们认为它们可能代表了一种独特的乳腺癌亚型,值得进一步研究。在这项研究中,我们的目的是在北非地区评估这种特殊亚型的临床病理特征和预后影响,在北非地区,her2低乳腺癌是一种研究相对不足的亚型,特别是在非西方人群中。方法。我们在卡萨布兰卡伊本罗得德大学医院病理部门和费斯哈桑二世大学医院病理部门收集了摩洛哥患者10年来的1955例乳腺肿瘤进行了回顾性队列研究。基于主要的乳腺癌生物标志物:Ki-67, HER2,雌激素和孕激素受体,我们详细阐述了他们完整的免疫组织化学谱。他们的总生存期和无病生存期数据也从各自的记录中检索。结果。在1955例BC患者中,49.3%归为her2低;激素受体阳性和阴性分别占80.7%和19.2%。临床病理特征表明her2低亚型肿瘤比her2阴性肿瘤表现得更像her2阳性肿瘤。生存分析显示,与her2阴性患者相比,her2低亚型患者的无病生存预后明显较差()。在考虑激素状态时,激素依赖性肿瘤根据HER2亚型在无病生存中表现出显著差异()。然而在激素阴性肿瘤中没有明显差异。此外,与激素阴性肿瘤相比,激素阳性肿瘤同时属于her2低亚组的患者的总生存预后明显较好()。结论。我们的研究表明her2低表型在激素阳性患者中很常见。临床病理特征和预后数据表明,激素受体的作用和HER2异质性是考虑的关键因素。值得注意的是,这个特殊的亚组不同于her2阴性的亚组,不应该用同样的方法治疗。因此,本研究为HER2-low患者的管理提供了一个新的视角,可以作为未来前瞻性分析的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Clinicopathological Features and Prognostic Significance of HER2-Low in Early Breast Tumors Patients Prognostic Comparison of HER-Low and HER2-Negative Breast Cancer Stratified by Hormone Receptor Status
Introduction. There has been increased interest in HER2-low breast tumors recently, as these tumors may have distinct clinical and molecular characteristics compared to HER2-negative and HER2-positive tumors. A new nomenclature has been proposed for HER2 1+ and HER2 2+ tumors that are confirmed negative according to fluorescence in situ hybridization (FISH). These tumors are now referred to as HER2-low, and it is thought that they may represent a distinct subtype of breast cancer that warrants further investigation. In this study, we aimed to evaluate the clinicopathological characteristics and prognostic impact of this particular subtype in a North-African context where HER2-low breast cancer is a relatively understudied subtype, particularly in non-Western populations. Methods. We conducted a retrospective cohort study on 1955 breast tumors in Moroccan patients over 10 years, collected at the Pathology Department of Ibn Rochd University Hospital in Casablanca and at the pathology department of Hassan II University Hospital in Fes. We elaborated on their complete immunohistochemical profile based on the main breast cancer biomarkers: Ki-67, HER2, estrogen, and progesterone receptors. Their overall survival and disease free survival data were also retrieved from their respective records. Results. Out of 1955 BC patients, 49.3% were classified as HER2-low; of which 80.7% and 19.2% were hormone receptors positive and negative, respectively. The clinicopathologic features indicate that HER2-low subtype tumors behave much more like HER2-positive than HER2-negative tumors. The survival analysis showed that the HER2-low subtype-belonging patients present significantly the poorest prognosis in disease-free survival () in comparison with HER2-negative ones. When considering the hormonal status, hormonal-dependent tumors show a significant difference according to HER2 subtypes in disease-free survival (). Yet no significant difference was shown among hormonal negative tumors. Moreover, patients with hormonal positive tumors and simultaneously belonging to the HER2-low subgroup present a significantly good prognosis in overall survival compared to the ones with hormonal negative tumors (). Conclusion. Our study has shown that the HER2-low phenotype is common among hormone-positive patients. The clinicopathological features and prognostic data indicate that the hormonal receptors effect and HER2 heterogeneity are crucial factors to consider. It is important to note that this particular subgroup is different from the HER2-negative one and should not be treated in the same way. Therefore, this study offers a new perspective in the management of HER2-low patients and can serve as a basis for future prospective analyses.
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