Xu Bin, Shen Jianguo, Zhang Liwen, Zhao Wenhe, Wang Linbo
Department of Surgical Oncology, Zhejiang University Medical School Affiliated Sir Run Run Shaw Hospital, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China.
Department of Surgical Oncology, Zhejiang University Medical School Affiliated Sir Run Run Shaw Hospital, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China.
Pathol Res Pract. 2022 Jun;234:153900. doi: 10.1016/j.prp.2022.153900. Epub 2022 Apr 16.
The purpose of this study was to determine whether the HER2 protein expression level assessed by immunochemistry (IHC) was related to the treatment response in HER2-positive breast cancer patients who received neoadjuvant chemotherapy.
167 HER2-positive breast cancer patients who had received neoadjuvant chemotherapy containing trastuzumab were included in this study. There were 27 HER2 2 + and 140 HER2 3 + cases. Using propensity score matching (PSM), the two groups were matched 1:3 by T stage, N stage, hormone receptor (HR) status, Ki67, and targeted therapy regimen. We performed univariate and multivariate analyses of the association between HER2 expression level and pathological complete response (pCR) rate.
The overall pCR rate was 43.7% (73/167). The pCR rate in the HER2 3 + group was significantly higher than in the HER2 2 + group (47.9% versus 22.2%, p = 0.014). After propensity score matching, 26 patients in the HER2 2 + group and 59 patients in the HER2 3 + group were matched. The pCR rate in the HER2 3 + group was still higher than in the HER2 2 + group (50.8% versus 19.2%, p = 0.006). Multivariate analysis showed that HER2 protein expression was an independent predictive factor for pCR (OR=5.353, 95% CI 1.649-17.379, p = 0.005). Additionally, the Ki67 index was also a significant factor for pCR (OR=3.702, 95% CI 1.327-10.326, p = 0.012).
For HER2-positive breast cancer patients, the HER2 protein expression level detected by IHC may be a good predictive factor for the efficacy of neoadjuvant chemotherapy.
本研究旨在确定通过免疫化学（IHC）评估的HER2蛋白表达水平是否与接受新辅助化疗的HER2阳性乳腺癌患者的治疗反应相关。
本研究纳入了167例接受含曲妥珠单抗新辅助化疗的HER2阳性乳腺癌患者。其中HER2 2 +病例27例，HER2 3 +病例140例。采用倾向评分匹配（PSM），根据T分期、N分期、激素受体（HR）状态、Ki67和靶向治疗方案将两组按1:3进行匹配。我们对HER2表达水平与病理完全缓解（pCR）率之间的关联进行了单因素和多因素分析。
总体pCR率为43.7%（73/167）。HER2 3 +组的pCR率显著高于HER2 2 +组（47.9%对22.2%，p = 0.014）。倾向评分匹配后，HER2 2 +组26例患者与HER2 3 +组59例患者匹配。HER2 3 +组的pCR率仍高于HER2 2 +组（50.8%对19.2%，p = 0.006）。多因素分析显示，HER2蛋白表达是pCR的独立预测因素（OR = 5.353，95%CI 1.649 - 17.379，p = 0.005）。此外，Ki67指数也是pCR的显著因素（OR = 3.702，95%CI 1.327 - 10.326，p = 0.012）。
对于HER2阳性乳腺癌患者，通过IHC检测的HER2蛋白表达水平可能是新辅助化疗疗效的良好预测因素。
