第二原发性肺癌中表皮生长因子受体（EGFR）突变与乳腺癌幸存者中人类表皮生长因子受体2（HER2）表达的相关性
Association of EGFR mutations in second primary lung cancer and HER2 expression in breast cancer survivors.
作者信息
Jang Yoon Jung, Kim Seo Yun, Jung Hong Kyu, Kim Hye-Ryoun, Kim Cheol Hyeon, Lee Hyo-Rak, Kang Hye Jin, Yang Sung Hyun, Seol Hyesil, Na Im Il
机构信息
Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea.
Division of Pulmonary and Critical Care Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological Sciences, Seoul, Korea.
出版信息
Transl Cancer Res. 2021 Dec;10(12):5204-5211. doi: 10.21037/tcr-21-1235.
BACKGROUND
The incidence of second primary lung cancer (SPLC) is increasing with longer survival rates from breast cancer. Despite of studies to suggest the mutual exclusivity of epidermal growth factor receptor (EGFR) and human epidermal growth receptor 2 (HER2) in several cancers, the effect of HER2 expression in breast cancer on EGFR mutations in SPLC is unclear. Therefore, this study aimed to determine the association between HER2 expression and EGFR mutations.
METHODS
We conducted a retrospective cohort study of breast cancer survivors diagnosed with SPLC after breast cancer treatment between 1997 and 2018. We investigated the association between HER2 expression in breast cancer and EGFR mutations in SPLC, specifically focusing on negative correlations by using logistic regression analysis.
RESULTS
EGFR mutations in SPLC were detected in 19 of 38 patients. Analysis for HER2 revealed a statistically significant difference in the proportion of EGFR mutations between patients with SPLC and previous HER2 positive breast cancer (43.5%) and those with SPLC and previous HER2 negative breast cancer (90.0%; P=0.021). The ratio of EGFR mutations decreased with the degree of HER2 expression in patients with previous breast cancer (90.0%: for no HER2 expression, 62.5% for HER2 1+, 0.0% for HER2 2+, and 41.7% for HER2 3+; P=0.018). Multivariate logistic analyses revealed that EGFR mutations in SPLC were significantly associated with age [odds ratio (OR): 1.11, 95% confidence interval (CI): 1.01-0.23, P=0.039] and HER2 positive status (OR: 0.04, 95% CI: 0.01-0.56, P=0.017).
CONCLUSIONS
This study suggests that the frequency of EGFR mutations in SPLC may be associated with low HER2 expression in previous breast cancer.
背景
随着乳腺癌生存率的提高，第二原发性肺癌（SPLC）的发病率正在上升。尽管有研究表明表皮生长因子受体（EGFR）和人表皮生长受体2（HER2）在几种癌症中相互排斥，但HER2在乳腺癌中的表达对SPLC中EGFR突变的影响尚不清楚。因此，本研究旨在确定HER2表达与EGFR突变之间的关联。
方法
我们对1997年至2018年期间乳腺癌治疗后诊断为SPLC的乳腺癌幸存者进行了一项回顾性队列研究。我们调查了乳腺癌中HER2表达与SPLC中EGFR突变之间的关联，特别通过逻辑回归分析关注负相关。
结果
38例患者中有19例检测到SPLC中的EGFR突变。对HER2的分析显示，SPLC患者与既往HER2阳性乳腺癌患者（43.5%）和SPLC患者与既往HER2阴性乳腺癌患者（90.0%；P=0.021）之间EGFR突变比例存在统计学显著差异。既往乳腺癌患者中，EGFR突变比例随HER2表达程度降低（HER2无表达为90.0%，HER2 1+为62.5%，HER2 2+为0.0%，HER2 3+为41.7%；P=0.018）。多因素逻辑分析显示，SPLC中的EGFR突变与年龄[比值比（OR）：1.11，95%置信区间（CI）：1.01-0.23，P=0.039]和HER2阳性状态（OR：0.04，95%CI：0.01-0.56，P=0.017）显著相关。
结论
本研究表明，SPLC中EGFR突变的频率可能与既往乳腺癌中HER2低表达有关。
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