Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
J Breast Cancer. 2014 Mar;17(1):33-9. doi: 10.4048/jbc.2014.17.1.33. Epub 2014 Mar 28.
The measurement of serum human epidermal growth factor receptor 2 (HER2) extracellular domain levels is a well-established method for evaluating whether a metastatic HER2-positive breast cancer patient will respond to HER2-targeted treatment. However, little is known about the value of serum HER2 for detecting disease relapse following curative surgical treatment in breast cancer patients. The purpose of this study was to evaluate the sensitivity of serum HER2, carcinoembryonic antigen (CEA), and carcinoma antigen 15-3 (CA 15-3) for the detection of disease recurrence in postoperative breast cancer patients with a primary HER2-positive tumor.
Serial measurements were taken of serum HER2, CEA, and CA 15-3 levels in patients with primary invasive HER2-positive breast cancer who underwent curative surgical treatment between January 2008 and December 2010. Following treatment, serum HER2 levels were monitored every 6 months using a chemiluminescence immunoassay.
Overall, 264 patients were analyzed in this retrospective study. The median follow-up period was 27.7 months, and 24 patients relapsed during follow-up. The sensitivity of serum HER2, CEA, and CA 15-3 for the detection of disease recurrence was 37.5%, 25.1%, and 12.5%, respectively. Sensitivity increased to 45.8% when all three tumor markers were combined in the analysis. In a subgroup of patients without liver disease, the sensitivity of serum HER2, CEA, and CA 15-3 was 57.1%, 21.4%, and 14.3%, respectively. Of the 264 patients in this study, 80 patients had chronic hepatitis, liver cirrhosis, or abnormal aspartate aminotransferase or alanine aminotransferase levels during the follow-up period. Following the exclusion of these patients, the sensitivity of serum HER2 for the detection of disease recurrence increased to 57.1%.
Serial serum HER2 measurement may be useful for the detection of disease relapse in patients with HER2-positive breast cancer. Abnormal liver function can result in elevated serum HER2 in the absence of disease recurrence.
血清人表皮生长因子受体 2（HER2）细胞外域水平的测定是评估转移性 HER2 阳性乳腺癌患者是否对 HER2 靶向治疗有反应的一种成熟方法。然而，对于检测接受根治性手术治疗的乳腺癌患者术后疾病复发时血清 HER2 的价值，人们知之甚少。本研究的目的是评估血清 HER2、癌胚抗原（CEA）和癌抗原 15-3（CA 15-3）在检测原发性 HER2 阳性肿瘤的乳腺癌患者术后疾病复发中的敏感性。
对 2008 年 1 月至 2010 年 12 月期间接受根治性手术治疗的原发性浸润性 HER2 阳性乳腺癌患者进行了连续的血清 HER2、CEA 和 CA 15-3 水平检测。治疗后，使用化学发光免疫分析法每 6 个月监测一次血清 HER2 水平。
在这项回顾性研究中，共分析了 264 例患者。中位随访时间为 27.7 个月，随访期间有 24 例患者复发。血清 HER2、CEA 和 CA 15-3 检测疾病复发的敏感性分别为 37.5%、25.1%和 12.5%。当所有三种肿瘤标志物联合分析时，敏感性增加至 45.8%。在无肝脏疾病的患者亚组中，血清 HER2、CEA 和 CA 15-3 的敏感性分别为 57.1%、21.4%和 14.3%。在本研究的 264 例患者中，有 80 例在随访期间患有慢性肝炎、肝硬化或天门冬氨酸氨基转移酶或丙氨酸氨基转移酶水平异常。排除这些患者后，血清 HER2 检测疾病复发的敏感性增加至 57.1%。
连续的血清 HER2 测量可能有助于检测 HER2 阳性乳腺癌患者的疾病复发。在没有疾病复发的情况下，异常肝功能可能导致血清 HER2 升高。
