Fehm T, Jäger W, Kraemer S, Sohn C, Solomayer-Meyberg G, Solomayer E F, Kurek R, Wallwiener D, Gebauer G
Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, D-72076 Tuebingen, Germany.
Anticancer Res. 2004 Nov-Dec;24(6):4205-10.
Serum HER2 testing allows the determination of the real-time HER2 status of breast cancer patients. The aim of this investigation was to study (i) whether changes of serum HER2 status occur during the clinical course of breast cancer and (ii) to evaluate the prognostic significance of serum HER2 status, at the time of first diagnosis of primary breast cancer and at the onset of metastatic disease, for survival after relapse (SAR).
HER2 serum levels were retrospectively measured in 152 breast cancer patients at the time of first diagnosis of breast cancer and at the onset of metastatic disease by enzyme immunoassay.
Twenty-seven out of 152 (18%) patients had elevated HER2 serum levels at the time of first diagnosis of breast cancer. In contrast, 56 out of 152 (37%) patients showed elevated serum HER2 levels when metastases were diagnosed. A change of serum HER2 status during clinical course was observed in 43 out of 152 (28%) patients. Serum HER2 status at the time of first diagnosis of breast cancer had no impact on survival after relapse (SAR) (p = 0.4). However, the median SAR for serum HER2-positive patients at the onset of metastatic disease was significantly shorter (8 months, 95% CI: 3-12) compared to patients serum HER2-negative at this time (18 months, 95% CI: 14-22) (p < 0.01).
Serum HER2 status can change during the course of disease. Therefore, the serum HER2 status should be re-evaluated at the time of diagnosis of metastatic disease to optimize treatment decisions.
血清HER2检测可确定乳腺癌患者的实时HER2状态。本研究的目的是探讨（i）乳腺癌临床病程中血清HER2状态是否发生变化，以及（ii）评估原发性乳腺癌首次诊断时和转移性疾病发生时血清HER2状态对复发后生存（SAR）的预后意义。
通过酶免疫测定法对152例乳腺癌患者在首次诊断乳腺癌时和转移性疾病发生时的HER2血清水平进行回顾性测量。
152例患者中有27例（18%）在首次诊断乳腺癌时HER2血清水平升高。相比之下，152例患者中有56例（37%）在诊断出转移时血清HER2水平升高。152例患者中有43例（28%）在临床病程中观察到血清HER2状态发生变化。乳腺癌首次诊断时的血清HER2状态对复发后生存（SAR）没有影响（p = 0.4）。然而，转移性疾病发生时血清HER2阳性患者的SAR中位数（8个月，95%CI：3 - 12）明显短于此时血清HER2阴性患者（18个月，95%CI：14 - 22）（p < 0.01）。
血清HER2状态可在疾病过程中发生变化。因此，在诊断转移性疾病时应重新评估血清HER2状态，以优化治疗决策。
