Sun Jong-Mu, Han Wonshik, Im Seock-Ah, Kim Tae-You, Park In Ae, Noh Dong-Young, Heo Dae Seog, Bang Yung-Jue, Choe Kuk Jin, Kim Noe Kyeong
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer. 2004 Dec 1;101(11):2516-22. doi: 10.1002/cncr.20665.
Adjuvant chemotherapy for patients with lymph node-negative breast carcinoma is being recommended currently based on the St. Gallen classification. The prognostic importance of HER-2 status in patients with lymph node-negative breast carcinoma has been investigated extensively, with contradictory results. The authors investigated the clinical relevance of HER-2 overexpression when combined with the St. Gallen classification in lymph node-negative breast carcinoma.
The medical records of patients with breast carcinoma negative for lymph node involvement who underwent surgery between January 1995 and December 2000 at the Seoul National University College of Medicine (Seoul, Korea) were reviewed retrospectively. Risk groups based on the St. Gallen classification were categorized as average or minimal risk. The prognostic values of HER-2 in combination with the St. Gallen classification were analyzed with respect to disease-free survival (DFS) rates.
A total of 906 patients were eligible for analysis. The overall 7-year DFS rate was 87.5%. The 7-year DFS rates for patients with HER-2-positive and HER-2-negative tumors were, respectively, 77.9% and 91.2% (P = 0.002). The 7-year DFS rates for patients with average and minimal risk group were 85.0% and 97.9%, respectively. The authors found that HER-2 overexpression significantly predicted the risk of disease recurrence (odds ratio = 3.03 [95% confidence interval, 1.63-5.63]). Furthermore, when HER-2 status was combined with the St. Gallen classification, the DFS rate of the HER-2-positive average risk group was 73.3% compared with 88.4% for the HER-2-negative average risk group (P = 0.007).
The combination of HER-2 overexpression and the St. Gallen classification was more useful than either alone to predict the risk of disease recurrence in patients with lymph node-negative breast carcinoma.
目前基于圣加仑分类法推荐对淋巴结阴性乳腺癌患者进行辅助化疗。HER-2状态在淋巴结阴性乳腺癌患者中的预后重要性已得到广泛研究，但结果相互矛盾。作者研究了HER-2过表达与圣加仑分类法相结合在淋巴结阴性乳腺癌中的临床相关性。
回顾性分析1995年1月至2000年12月在韩国首尔国立大学医学院接受手术的淋巴结阴性乳腺癌患者的病历。基于圣加仑分类法的风险组分为平均风险或低风险。结合圣加仑分类法分析HER-2对无病生存率（DFS）的预后价值。
共有906例患者符合分析条件。总体7年DFS率为87.5%。HER-2阳性和HER-2阴性肿瘤患者的7年DFS率分别为77.9%和91.2%（P = 0.002）。平均风险组和低风险组患者的7年DFS率分别为85.0%和97.9%。作者发现HER-2过表达显著预测疾病复发风险（比值比 = 3.03 [95%置信区间，1.63 - 5.63]）。此外，当HER-2状态与圣加仑分类法相结合时，HER-2阳性平均风险组的DFS率为73.3%，而HER-2阴性平均风险组为88.
