Diao Wei-Ying, Ding Cheng-Long, Yuan Bo-Yang, Li Zan, Sun Na, Huang Jia-Bin
Department of Pathology, The First Affiliated Hospital of Jiamusi University, Jimusi City, Heilongjiang Province, 154002, People's Republic of China.
Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Jiamusi University, Jimusi City, Heilongjiang Province, 154002, People's Republic of China.
Int J Gen Med. 2021 Dec 1;14:9153-9161. doi: 10.2147/IJGM.S328908. eCollection 2021.
We aim to investigate the relationship between HER2 gene phenotype and clinical characteristics, distribution and prognosis of non-small cell lung cancer (NSCLC) patients.
A total of 249 NSCLC patients admitted to the oncology department of our hospital from January 2015 to January 2018 were retrospectively analyzed. The clinicopathological information, CT signs, clinical efficacy and long-term prognosis were collected and compared.
A total of 249 NSCLC patients underwent HER2 gene testing, 21 of them (8.43%) complied with HER2 alterations [HER2 (+)], and there were significant differences in tumor stages among patients with different HER2 phenotypes (<0.05). Among 21 NSCLC patients with HER2 (+), HER2 gene mutation was found in 17 patients (81%), and HER2 gene amplification in 4 patients (19%). Among the HER2 mutations, 12 cases (57%) were 20 exon mutations, and 5 cases (19%) were other mutations. Analysis of CT signs showed that border lobulation/burr, necrosis sign and pleural depression were correlated with HER2 gene mutation (<0.05). The incidence of EGRF mutation in HER (+) patients was significantly lower than that in HER (-) patients (<0.05), but there was no significant difference in the incidence of ALK gene mutation among different HER phenotypes (>0.05). The disease control rate of HER2 (+) patients was significantly lower than that of HER2 (-) patients, and the 12-month progression-free survival rate and survival rate of HER2 (+) patients were significantly higher than those of HER2 (-) patients (<0.05). There was no significant difference in the incidence of ADR among HER2 patients with different phenotypes, but the incidence of ADR (adverse drug reaction) in HER2 (+) patients with Grade 3 or 4 was significantly higher than that in the control group (<0.05).
The incidence of HER2 gene mutations in NSCLC patients is relatively low, but it is far commoner in patients with stage IIIB~IV, among which exon 20 mutations are the most prevalent. In CT signs, the lesion lobulated sign/spiculated sign, necrosis signs, and pleural depression signs are related to HER2 gene mutations. In addition, HER2 gene mutations play a crucial role in the clinical prognosis and treatment safety of patients.
我们旨在研究非小细胞肺癌（NSCLC）患者中HER2基因表型与临床特征、分布及预后之间的关系。
回顾性分析2015年1月至2018年1月我院肿瘤科收治的249例NSCLC患者。收集并比较其临床病理信息、CT征象、临床疗效及长期预后。
共249例NSCLC患者接受了HER2基因检测，其中21例（8.43%）符合HER2改变[HER2(+)]，不同HER2表型患者的肿瘤分期存在显著差异（<0.05）。在21例HER2(+)的NSCLC患者中，17例（81%）检测到HER2基因突变，4例（19%）检测到HER2基因扩增。在HER2突变中，12例（57%）为20外显子突变，5例（19%）为其他突变。CT征象分析显示，边界分叶/毛刺、坏死征象及胸膜凹陷与HER2基因突变相关（<0.05）。HER(+)患者中EGRF突变的发生率显著低于HER(-)患者（<0.05），但不同HER表型患者中ALK基因突变的发生率无显著差异（>0.05）。HER2(+)患者的疾病控制率显著低于HER2(-)患者，HER2(+)患者的12个月无进展生存率和生存率显著高于HER2(-)患者（<0.05）。不同表型的HER2患者中ADR的发生率无显著差异，但3级或4级HER2(+)患者中ADR（药物不良反应）的发生率显著高于对照组（<0.05）。
NSCLC患者中HER2基因突变的发生率相对较低，但在IIIB~IV期患者中更为常见，其中20外显子突变最为普遍。在CT征象中，病灶分叶征/毛刺征、坏死征象及胸膜凹陷征与HER2基因突变有关。此外，HER2基因突变在患者的临床预后及治疗安全性中起关键作用。
