Medical College of Wisconsin, Milwaukee, WI, USA.
University of Florida, Gainsville, FL, USA.
Breast J. 2021 Aug;27(8):631-637. doi: 10.1111/tbj.14241. Epub 2021 May 20.
Human Epidermal Growth Factor Receptor 2 (HER2), a routinely tested breast cancer marker, is associated with worse prognosis yet increased sensitivity to targeted neoadjuvant therapy (NAT) in breast cancer patients. The presence of HER2 in breast carcinoma can be detected with either immunohistochemistry (IHC) or in situ hybridization (ISH). In this study, we examine the relationship between clinicopathological features, HER2 detection method (IHC vs ISH), and prognostic outcomes in NAT-treated HER2-positive breast cancer patients. We included 99 HER2-positive patients from three academic institutions following 2018 HER2 testing updates and conducted a retrospective correlational study. Seventy-one (72%) were HER2-positive by IHC and 28 (28%) were positive following reflexive ISH. Multivariate analysis showed biomarker status to be significantly associated with pathologic complete response (pCR) (p = 0.003), Residual Cancer Burden (RCB) (p = 0.007), and tumor size downstaging (p = 0.002) and HER2 detection method of IHC to be significantly associated with pCR (p = 0.05), RCB (p = 0.004), and nodal downstaging (p= 0.03). In conclusion, HER2 detection method and biomarker subtype allow for further prognostic stratification of HER2-positive patients when 2018 American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline updates are applied.
人表皮生长因子受体 2（HER2）是一种常规检测的乳腺癌标志物，与乳腺癌患者的预后较差相关，但对靶向新辅助治疗（NAT）的敏感性增加。HER2 在乳腺癌中的存在可以通过免疫组织化学（IHC）或原位杂交（ISH）来检测。在这项研究中，我们研究了临床病理特征、HER2 检测方法（IHC 与 ISH）与接受 NAT 治疗的 HER2 阳性乳腺癌患者预后结果之间的关系。我们纳入了来自三个学术机构的 99 例 2018 年 HER2 检测更新后符合条件的 HER2 阳性患者，并进行了回顾性相关性研究。71 例（72%）患者的 HER2 状态通过 IHC 检测呈阳性，28 例（28%）患者通过反射性 ISH 检测呈阳性。多变量分析显示，生物标志物状态与病理完全缓解（pCR）（p=0.003）、残留癌负荷（RCB）（p=0.007）和肿瘤大小降期（p=0.002）显著相关，且 IHC 检测方法与 pCR（p=0.05）、RCB（p=0.004）和淋巴结降期（p=0.03）显著相关。总之，当应用 2018 年美国临床肿瘤学会（ASCO）/美国病理学家协会（CAP）指南更新时，HER2 检测方法和生物标志物亚型可进一步对 HER2 阳性患者进行预后分层。
