Discipline of Medicine, Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei.
Department of Medical Oncology, The Brunei Cancer Centre, Jerudong, Brunei Darussalam.
Cancer Rep (Hoboken). 2020 Oct;3(5):e1249. doi: 10.1002/cnr2.1249. Epub 2020 Jun 8.
Breast cancer is one of the leading cancers among females of Brunei Darussalam. There are four subtypes of breast cancer, including human epidermal growth factor receptor 2 (HER-2) positive breast cancer, which is known to be more aggressive and have a poor prognosis.
This study aims to assess the proportion of HER-2 positive cases and the association of HER-2 positivity with patients' epidemiological and clinicopathological factors in Brunei Darussalam.
A total of 146 breast cancer cases that were sent for fluorescence in situ hybridisation (FISH) analysis from 1 January 2012 to 31 December 2016 were obtained from The Brunei Cancer Centre, Brunei Darussalam. Data analysis was done with regards to age at diagnosis, ethnicity, stage at diagnosis and HER-2 results by immunohistochemistry (IHC) and FISH. Majority of the study population were diagnosed before the age of 50 years and the median age was 52.0 years. 58.2% (n = 85) cases were reported as IHC 3+, followed by 23.3% (n = 34) IHC 2+ cases and 18.5% (n = 27) negative cases. The proportion of true HER-2 positive cases in total by FISH analysis was 34.9% (n = 51). Majority of Stage IV HER-2 positive cases had metastases to the liver or bones.
Age at diagnosis is significant in determining HER-2 status of tumours by FISH (P = .045). Tumour size (P < .001) and lymph node (P = .006) are significant in metastases of tumours. The proportion of HER-2 positive cases is consistent with findings from the Asian region but higher than that of Western countries. Determining false-positive and false-negative results by IHC test is important to ensure adequate treatment for patients with breast cancer.
乳腺癌是文莱达鲁萨兰国女性中最常见的癌症之一。乳腺癌有四种亚型，包括人表皮生长因子受体 2（HER-2）阳性乳腺癌，这种乳腺癌通常更具侵袭性且预后较差。
本研究旨在评估文莱达鲁萨兰国 HER-2 阳性病例的比例以及 HER-2 阳性与患者流行病学和临床病理因素之间的相关性。
从 2012 年 1 月 1 日至 2016 年 12 月 31 日，从文莱癌症中心获得了 146 例经荧光原位杂交（FISH）分析的乳腺癌病例。对诊断时的年龄、种族、诊断时的分期和免疫组织化学（IHC）和 FISH 检测的 HER-2 结果进行了数据分析。研究人群的大多数患者在 50 岁之前被诊断出患有疾病，中位年龄为 52.0 岁。85 例（58.2%）病例被报告为 IHC 3+，其次是 34 例（23.3%）IHC 2+病例和 27 例（18.5%）阴性病例。通过 FISH 分析，真正的 HER-2 阳性病例比例为 34.9%（n = 51）。大多数 IV 期 HER-2 阳性病例的转移部位为肝脏或骨骼。
FISH 检测（P =.045）确定肿瘤的 HER-2 状态时，诊断时的年龄是显著相关的。肿瘤大小（P < .001）和淋巴结（P =.006）与肿瘤转移显著相关。HER-2 阳性病例的比例与亚洲地区的发现一致，但高于西方国家。通过 IHC 检测确定假阳性和假阴性结果对于确保乳腺癌患者获得充分治疗非常重要。
