Pichon Marie-France, Hacene Kamel, Guepratte Sylvie, Neumann Rainer
Laboratoire d'Oncobiologie, Centre René Huguenin Saint-Cloud, France.
Clin Lab. 2004;50(3-4):163-70.
We studied the serum HER-2 extracellular domain (sHER-2) before the first metastases in 128/701 breast cancer patients diagnosed and followed-up in our institution who developed metastases as the first relapse. sHER-2 was measured by an enzyme-linked immnunosorbent assay and CA 15.3 by an immunoradiometric assay. Non-parametric statistics were used. sHER-2 and CA 15.3 before and after primary treatment were measured in a previous part of the study. Before first metastases, 45% of the samples were over 12 microg/l of sHER-2 (cut-off) and were significantly related to sHER-2 values before and after primary treatment (P = 0.0350 and P < 0.0001 respectively). Concordance with CA 15.3 was 56.25 % (weak correlation, rho = 0.263). sHER-2 levels differed according to the sites of the metastases (P = 0.0199), the highest levels were found in liver and lung metastases. A median sHER-2 lead time of 254 days was found for 18/28 (64.3 %) patients before first metastasis. Pre-metastatic sHER-2 levels showed strong univariate (Kaplan-Meier method, P = 0.0014) and multivariate prognostic values (Cox model, P < 0.0001) for survival after first metastasis. In recurrent breast cancer, elevated levels of sHER-2 enabled an early detection of occult metastases and the identification of patients with a high probability of shortened survival.
我们对在我院确诊并随访的701例乳腺癌患者中的128例进行了研究，这些患者首次复发为转移，我们检测了其首次转移前的血清HER-2细胞外结构域（sHER-2）。采用酶联免疫吸附测定法检测sHER-2，采用免疫放射测定法检测CA 15.3。使用非参数统计方法。在该研究的前一部分中测量了初次治疗前后的sHER-2和CA 15.3。在首次转移前，45%的样本sHER-2超过12μg/l（临界值），且与初次治疗前后的sHER-2值显著相关（分别为P = 0.0350和P < 0.0001）。与CA 15.3的一致性为56.25%（弱相关性，rho = 0.263）。sHER-2水平根据转移部位不同而有所差异（P = 0.0199），在肝转移和肺转移中水平最高。在18/28例（64.3%）患者中发现首次转移前sHER-2的中位提前期为254天。转移前sHER-2水平对首次转移后的生存显示出很强的单因素（Kaplan-Meier法，P = 0.0014）和多因素预后价值（Cox模型，P < 0.0001）。在复发性乳腺癌中，sHER-2水平升高有助于早期发现隐匿性转移并识别生存概率可能缩短的患者。
