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高危子宫内膜癌中的HER2状态(PORTEC-3):与组织类型、分子分类及临床结局的关系

HER2 Status in High-Risk Endometrial Cancers (PORTEC-3): Relationship with Histotype, Molecular Classification, and Clinical Outcomes.

作者信息

Vermij Lisa, Horeweg Nanda, Leon-Castillo Alicia, Rutten Tessa A, Mileshkin Linda R, Mackay Helen J, Leary Alexandra, Powell Melanie E, Singh Naveena, Crosbie Emma J, Smit Vincent T H B M, Creutzberg Carien L, Bosse Tjalling

机构信息

Department of Pathology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.

Department of Radiation Oncology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.

出版信息

Cancers (Basel). 2020 Dec 25;13(1):44. doi: 10.3390/cancers13010044.

Abstract

HER2 status has not been investigated in the context of the molecular endometrial cancer (EC) classification. Here, we aimed to determine the clinicopathological features and prognostic significance of the HER2 status in the molecularly classified PORTEC-3 trial population of patients with high-risk EC (HREC). HER2 testing was performed on tumor tissues of 407 molecularly classified HREC. HER2 status was determined by HER2 immunohistochemistry (IHC; all cases) and subsequent HER2 dual in situ hybridization for cases with any (in) complete moderate to strong membranous HER2 IHC expression. The Χ test and Spearman's Rho correlation coefficient were used to compare clinicopathological and molecular features. The Kaplan-Meier method, log-rank test, and Cox proportional hazards models were used for survival analysis. We identified 24 (5.9%) HER2-positive EC of various histological subtypes including serous ( = 9, 37.5%), endometrioid ( = 6, 25.0%), and clear cell ( = 5, 20.8%). HER2 positivity was highly associated with the p53-abnormal subgroup (p53abn, 23/24 cases; < 0.0001). The correlation between p53abn and the HER2 status (ρ = 0.438; < 0.0001) was significantly stronger ( < 0.0001) than between serous histology and the HER2 status (ρ = 0.154; = 0.002). HER2 status did not have independent prognostic value for survival after correction for the molecular classification. Our study strongly suggests that molecular subclass-directed HER2 testing is superior to histotype-directed testing. This insight will be relevant for future trials targeting HER2.

摘要

尚未在分子子宫内膜癌(EC)分类的背景下研究HER2状态。在此,我们旨在确定高危EC(HREC)患者分子分类的PORTEC-3试验人群中HER2状态的临床病理特征和预后意义。对407例分子分类的HREC肿瘤组织进行了HER2检测。通过HER2免疫组织化学(IHC;所有病例)以及随后对任何(不完全)中度至强膜性HER2 IHC表达的病例进行HER2双重原位杂交来确定HER2状态。采用χ检验和Spearman等级相关系数比较临床病理和分子特征。采用Kaplan-Meier法、对数秩检验和Cox比例风险模型进行生存分析。我们鉴定出24例(5.9%)HER2阳性EC,包括各种组织学亚型,如浆液性(n = 9,37.5%)、子宫内膜样(n = 6,25.0%)和透明细胞(n = 5,20.8%)。HER2阳性与p53异常亚组高度相关(p53abn,23/24例;P < 0.0001)。p53abn与HER2状态之间的相关性(ρ = 0.438;P < 0.0001)显著强于浆液性组织学与HER2状态之间的相关性(ρ = 0.154;P = 0.002)(P < 0.0001)。校正分子分类后,HER2状态对生存没有独立的预后价值。我们的研究强烈表明,分子亚类导向的HER2检测优于组织学类型导向的检测。这一见解将与未来针对HER2的试验相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2dc/7795222/4b30447e352a/cancers-13-00044-g001.jpg

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