Ignatov Tanja, Eggemann Holm, Burger Elke, Fettke Franziska, Costa Serban Dan, Ignatov Atanas
Department of Obstetrics and Gynecology, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany.
Breast Cancer Res Treat. 2015 Jun;151(2):357-64. doi: 10.1007/s10549-015-3407-2. Epub 2015 Apr 30.
Overexpression of human epidermal growth factor receptor 2 (HER2) is an important prognostic and predictive marker of response to anti-HER2 therapy in breast cancer. Our goal was to analyze the prognostic significance of moderate expression of HER2 in breast cancer with intermediate differentiation grade. We performed a multicenter retrospective register study of 8494 patients with primary non-metastatic breast cancer admitted between 2000 and 2011 to eight Clinics in Saxony-Anhalt, federal state of Germany. Patients were divided into three groups according to their HER2 score: 4073 were classified as HER2 negative (HER2 0 and 1+), 822 HER2 moderate (HER2 2+/HER2), and 1238 HER2 positive (HER2 3+ or HER2 2+/HER2+). HER2-positive cases were excluded from analysis. Tumors with moderate HER2 (HER2 2+) expression demonstrated an aggressive behavior and worse patient survival compared with HER2 0 and 1+ status. HER2 2+ status was associated with shorter median overall survival (OS) (P < 0.0001) in breast cancer patients with an intermediate grade of differentiation. Comparing low-grade and high-grade tumors, HER2 moderate expression did not significantly influence patient survival. In multivariate analysis after adjustment for other prognostic factors HER2 2+ status remained an unfavorable prognostic factor for OS (HR 1.224, 95 % CI 1.059-1.415, P = 0.006) in breast cancer patients with an intermediate grade of differentiation. HER2 2+ status is an unfavorable prognostic factor regarding the OS of breast cancer patients with intermediate grade of differentiation and could be used to identify patients, who may benefit from adjuvant therapy.
人表皮生长因子受体2（HER2）的过表达是乳腺癌抗HER2治疗反应的重要预后和预测标志物。我们的目标是分析HER2中度表达在中度分化乳腺癌中的预后意义。我们对2000年至2011年间德国萨克森 - 安哈尔特州八家诊所收治的8494例原发性非转移性乳腺癌患者进行了一项多中心回顾性登记研究。根据HER2评分将患者分为三组：4073例被归类为HER2阴性（HER2 0和1+），822例HER2中度（HER2 2+/HER2），1238例HER2阳性（HER2 3+或HER2 2+/HER2+）。HER2阳性病例被排除在分析之外。与HER2 0和1+状态相比，HER2中度（HER2 2+）表达的肿瘤表现出侵袭性行为且患者生存率更差。在中度分化的乳腺癌患者中，HER2 2+状态与较短的中位总生存期（OS）相关（P < 0.0001）。比较低级别和高级别肿瘤，HER2中度表达对患者生存率没有显著影响。在对其他预后因素进行调整后的多变量分析中，HER2 2+状态仍然是中度分化乳腺癌患者OS的不良预后因素（HR 1.224，95% CI 1.059 - 1.415，P = 0.006）。HER2 2+状态是中度分化乳腺癌患者OS的不良预后因素，可用于识别可能从辅助治疗中获益的患者。
