Hetzel D J, Wilson T O, Keeney G L, Roche P C, Cha S S, Podratz K C
Section of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Gynecol Oncol. 1992 Nov;47(2):179-85. doi: 10.1016/0090-8258(92)90103-p.
The HER-2/neu oncogene encodes for a specific cell-surface glycoprotein similar to the human growth factor receptor. An analysis of 247 patients with endometrial cancer treated between 1979 and 1983 was performed using an immunoperoxidase technique on paraffin-embedded tissue samples to detect HER-2/neu overexpression. Specimens were graded blindly with regard to HER-2/neu staining intensity. Overexpression of HER-2/neu was identified as strong in 37 patients (15%), mild in 144 (58%), and none in 66 (27%). The 5-year progression-free survival was 56% for the strong, 83% for the mild, and 95% for the nonstaining groups. The strong (P < 0.0001) and the mild (P = 0.028) staining groups were distinct from the nonstaining group in predicting progression-free survival. Likewise, strong overexpression was associated with a poor (51%) overall survival (P < 0.0001). Multivariate analysis revealed that intense overexpression had independent significance in predicting progression-free (P = 0.0003) and overall survival (P < 0.0001). In stage I patients (203), the 5-year progression-free survival was 62% for the strong and 97% for the nonstaining groups (P = 0.0007). This retained independent significance when subjected to multivariate analysis (P = 0.0017). Other significant stage I prognostic factors in multivariate analysis included DNA ploidy, histologic subtype, and histologic grade but not depth of invasion.
HER-2/neu癌基因编码一种特定的细胞表面糖蛋白，类似于人类生长因子受体。采用免疫过氧化物酶技术，对1979年至1983年间接受治疗的247例子宫内膜癌患者的石蜡包埋组织样本进行分析，以检测HER-2/neu的过表达情况。对标本的HER-2/neu染色强度进行盲法分级。HER-2/neu过表达被确定为37例（15%）强阳性、144例（58%）弱阳性和66例（27%）无阳性。强阳性组、弱阳性组和无染色组的5年无进展生存率分别为56%、83%和95%。在预测无进展生存率方面，强阳性组（P<0.0001）和弱阳性组（P=0.028）与无染色组明显不同。同样，强过表达与较差的总生存率（51%）相关（P<0.0001）。多变量分析显示，强烈过表达在预测无进展生存率（P=0.0003）和总生存率（P<0.0001）方面具有独立意义。在I期患者（203例）中，强阳性组和无染色组的5年无进展生存率分别为62%和97%（P=0.0007）。在进行多变量分析时，这一结果仍具有独立意义（P=0.0017）。多变量分析中其他重要的I期预后因素包括DNA倍体、组织学亚型和组织学分级，但不包括浸润深度。
