Department of Internal Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, South Korea.
Jpn J Clin Oncol. 2011 May;41(5):593-9. doi: 10.1093/jjco/hyr020. Epub 2011 Mar 15.
Recent studies have shown that the human epidermal growth factor receptor 2 status of a metastatic site may differ from that of the primary site. This difference may influence patient prognosis and response to therapy.
We conducted a retrospective study using immunohistochemistry and/or fluorescent in situ hybridization to compare human epidermal growth factor receptor 2 and hormone receptor status in primary and metastatic breast cancers.
Fifty-six patients were included in this study. Conversion from hormone receptor positive in the primary tumor to hormone receptor negative in the metastasis occurred in 12 patients (21.4%), and hormone receptor negative to hormone receptor positive conversion occurred in two patients (3.6%). Human epidermal growth factor receptor 2 status was discordant between primary and metastatic lesions in seven patients (12.5%). All of the five patients who converted from human epidermal growth factor receptor 2 negative status to human epidermal growth factor receptor positive received trastuzumab-based chemotherapy. Overall response rate and median progression-free survival for concordant human epidermal growth factor receptor 2 positive patients were 69.2% and 16.9 months, whereas that of patients with positive conversion of human epidermal growth factor receptor 2 were 40.0% and 7.6 months, respectively (overall response rate; P = 0.169 and progression-free survival; P = 0.004).
Discordance in human epidermal growth factor receptor 2 and hormone receptor status between primary and metastatic tumors was observed, which led to altered treatment decisions. Evaluation of human epidermal growth factor receptor 2 and hormone receptor in metastatic tumors should be considered in patients with breast cancer.
最近的研究表明，转移部位的人表皮生长因子受体 2 状态可能与原发性部位不同。这种差异可能会影响患者的预后和对治疗的反应。
我们使用免疫组织化学和/或荧光原位杂交法对原发性和转移性乳腺癌中的人表皮生长因子受体 2 和激素受体状态进行了回顾性比较。
本研究共纳入 56 例患者。12 例（21.4%）患者原发肿瘤中激素受体阳性转化为转移瘤中激素受体阴性，2 例（3.6%）患者激素受体阴性转化为激素受体阳性。7 例（12.5%）患者人表皮生长因子受体 2 状态在原发灶和转移灶之间不一致。所有 5 例从人表皮生长因子受体 2 阴性状态转为人表皮生长因子受体 2 阳性的患者均接受了曲妥珠单抗为基础的化疗。人表皮生长因子受体 2 阳性患者的总体缓解率和中位无进展生存期分别为 69.2%和 16.9 个月，而人表皮生长因子受体 2 阳性转化患者的总体缓解率和中位无进展生存期分别为 40.0%和 7.6 个月（总体缓解率；P = 0.169，无进展生存期；P = 0.004）。
原发灶和转移灶中人表皮生长因子受体 2 和激素受体状态不一致，导致治疗决策改变。应考虑在乳腺癌患者中评估转移性肿瘤中人表皮生长因子受体 2 和激素受体。
