Schippinger Walter, Dandachi Nadia, Regitnig Peter, Hofmann Günter, Balic Marija, Neumann Rainer, Samonigg Hellmut, Bauernhofer Thomas
Department of Internal Medicine, Division of Oncology, Medical University of Graz, Graz, Austria.
Am J Clin Pathol. 2007 Oct;128(4):630-7. doi: 10.1309/51KPD70348RP6XTE.
We investigated the predictive value of HER-2/neu and epidermal growth factor receptor (EGFR) in tumor tissue and prechemotherapy serum for histopathologic response in 108 patients with breast cancer undergoing neoadjuvant anthracycline-based chemotherapy. Response to chemotherapy, assessed by histopathologic classification of regression (grade 0 [no therapy effect] to 4 [no residual tumor]), correlated significantly with prechemotherapy serum HER-2/neu levels. Median prechemotherapy serum HER-2/neu levels were significantly higher in patients with regression grades 1 through 4 compared with those in patients with regression grade 0 (9.6 vs 8.55 ng/mL; P = .011; 95% confidence interval [CI], .009-.014). Median pretreatment serum HER-2/neu levels of patients with complete pathologic response (pCR) were significantly higher than in patients with moderate or no treatment response (10.95 vs 9.1 ng/mL; P = .041; 95% CI, .036-.046). Receiver operating characteristic curve analysis revealed a serum HER-2/neu value of more than 10.3 ng/mL to predict a pCR with 80% sensitivity and 69.4% specificity. There was no significant correlation of response with HER-2/neu and EGFR scores in tumor tissue or with serum EGFR levels. Results demonstrate prechemotherapy serum HER-2/neu to be a significant predictor of response to neoadjuvant anthracycline-based chemotherapy for breast cancer.
我们研究了108例接受以蒽环类药物为基础的新辅助化疗的乳腺癌患者肿瘤组织及化疗前血清中HER-2/neu和表皮生长因子受体(EGFR)对组织病理学反应的预测价值。通过回归的组织病理学分类(0级[无治疗效果]至4级[无残留肿瘤])评估化疗反应,其与化疗前血清HER-2/neu水平显著相关。与回归0级的患者相比,回归1至4级的患者化疗前血清HER-2/neu水平中位数显著更高(9.6对8.55 ng/mL;P = 0.011;95%置信区间[CI],0.009 - 0.014)。完全病理缓解(pCR)患者的预处理血清HER-2/neu水平中位数显著高于中度或无治疗反应的患者(10.95对9.1 ng/mL;P = 0.041;95% CI,0.036 - 0.046)。受试者工作特征曲线分析显示,血清HER-2/neu值大于10.3 ng/mL时预测pCR的敏感性为80%,特异性为69.4%。肿瘤组织中HER-2/neu和EGFR评分或血清EGFR水平与反应无显著相关性。结果表明,化疗前血清HER-2/neu是乳腺癌对以蒽环类药物为基础的新辅助化疗反应的重要预测指标。