Naeem Mohammad, Nasir Amir, Aman Zahid, Ahmad Tariq, Samad Ambreen
Department of Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2008 Jul-Sep;20(3):23-6.
Carcinoma breast is the commonest malignancy of females all over the world and second leading cause of death due to cancer among females. In Pakistan it is more common at a young age contrary to the West where it is more common in old age (after 60 years). The objectives of this cross sectional study were to determine the frequency of HER-2/neu receptor over-expression and its association with some of the features of breast cancer like patient age, ER/PR status, tumour size, histological grade and axillary lymph node involvement.
This study was conducted at Surgical C Unit, Postgraduate Medical Institute of Lady Reading Hospital, Peshawar, from January 2007 to December 2007. Study included all patients with breast cancer admitted in Surgical 'C' unit LRH, Peshawar for Modified Radical Mastectomy (MRM). The resected specimens were sent to histopathologist for immunohistochemical (IHC) studies (HER-2/neu receptor and ER/PR) and detailed histopathological analysis including tumour subtype, size, histological grade and involvement of axillary lymph nodes. Patients refusing HER-2/neu receptor immunohistochemistry were excluded from the study. Name, age, sex, other relevant data, detailed history and clinical examination findings and results of investigation were recorded. Data was analyzed with SPSS version 10.
This study included 24 female patients of breast cancer having modified radical mastectomy (MRM). Age distribution ranged from 32-75 years with a Mean +/- SD of age 48.3 +/- 18.2 years. Fifteen out of 24 patients (62.5%) were >40 years, while nine patients out of 24 (37.5%) were <40 years of age. The HER-2/neu receptor status was found positive in 11 patients (45.9%) and negative in 13 patients (54%) of the total cases. HER-2/neu receptor positivity was not significantly associated with histopathological sub-type (p > 0.05), number of axillary lymph nodes involved (p > 0.05) and histological grade (p > 0.05). While, it was significantly associated with tumour size (p < 0.05) and negative ER/PR status (p < 0.05).
Due to high prognostic significance and frequency in Pakistani females with breast cancer, HER-2/neu receptor should be checked in all patients with breast cancer so that the positive cases should have herceptin therapy and benefit from anthracycline based chemotherapeutic agents which can improve survival in these patients.
乳腺癌是全球女性最常见的恶性肿瘤，也是女性癌症死亡的第二大主要原因。在巴基斯坦，乳腺癌在年轻女性中更为常见，这与西方国家不同，在西方国家乳腺癌在老年女性（60岁以后）中更为常见。本横断面研究的目的是确定HER-2/neu受体过表达的频率及其与乳腺癌某些特征的关系，如患者年龄、雌激素受体/孕激素受体（ER/PR）状态、肿瘤大小、组织学分级和腋窝淋巴结受累情况。
本研究于2007年1月至2007年12月在白沙瓦Lady Reading医院研究生医学研究所外科C病房进行。研究纳入了所有因改良根治性乳房切除术（MRM）入住白沙瓦LRH外科C病房的乳腺癌患者。切除的标本被送往组织病理学家处进行免疫组织化学（IHC）研究（HER-2/neu受体和ER/PR）以及详细的组织病理学分析，包括肿瘤亚型、大小、组织学分级和腋窝淋巴结受累情况。拒绝进行HER-2/neu受体免疫组织化学检测的患者被排除在研究之外。记录患者的姓名、年龄、性别、其他相关数据、详细病史、临床检查结果和检查结果。数据用SPSS 10版进行分析。
本研究包括接受改良根治性乳房切除术（MRM）的24例女性乳腺癌患者。年龄分布在32至75岁之间，平均年龄±标准差为48.3±18.2岁。24例患者中有15例（62.5%）年龄大于40岁，24例中有9例（37.5%）年龄小于40岁。在所有病例中，HER-2/neu受体状态在11例患者（45.9%）中呈阳性，在13例患者（54%）中呈阴性。HER-2/neu受体阳性与组织病理学亚型（p>0.05）、腋窝淋巴结受累数量（p>0.05）和组织学分级（p>0.05）无显著相关性。然而，它与肿瘤大小（p<0.05）和ER/PR阴性状态（p<0.05）显著相关。
由于HER-2/neu受体在巴基斯坦乳腺癌女性患者中具有较高的预后意义和出现频率，所有乳腺癌患者均应检测该受体，以便阳性病例能够接受赫赛汀治疗，并从基于蒽环类的化疗药物中获益，这可以提高这些患者的生存率。
