Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2022 Jun 16;13:874815. doi: 10.3389/fendo.2022.874815. eCollection 2022.
The role of human epidermal growth factor receptor 2 (HER2) in metaplastic breast cancer (MBC) patients remains unclear. The present study aimed to evaluate the effect of HER2 status on MBC patients by propensity-score matching (PSM).
The SEER data from 2010 to 2016 were extracted. The breast cancer-specific survival (BCSS) of MBC patients, diagnosed from 2001 to 2016, was compared using Kaplan-Meier analysis. The multivariate Cox proportional model between groups was performed. PSM was used to make 1:1 case-control matching.
We included 1887 patients with a median follow-up time of 28 months (range 1-83 months). 1749 (92.7%) and 138 (7.3%) patients presented in the HER2-negative group and HER2-positive group. 833 (44.1%) patients received post-mastectomy radiotherapy (PMRT). The HER2-positive group had younger patients, lower tumor grades, and more advanced tumor stages. The prognoses were related to age of diagnosis, race/ethnicity, TNM stage, and PMRT in multivariate Cox analysis. ER status and HER2 status had no impact on BCSS. In the Kaplan-Meier analysis, PMRT was associated with a better prognosis. Importantly, patients with HER2-negative status can benefit from PMRT, but not those with HER2-positive status. After PSM, on multivariate Cox analysis, the prognosis was related to HER2 status and PMRT. In the Kaplan-Meier analysis, PMRT was related to a better prognosis for HER2-negative patients.
Our findings supported that PMRT and HER2-positive status were associated with a better prognosis after PSM. However, HER2-negative, but not HER2-positive patients could benefit from PMRT.
人表皮生长因子受体 2（HER2）在乳腺型多形性癌（MBC）患者中的作用尚不清楚。本研究旨在通过倾向评分匹配（PSM）评估 HER2 状态对 MBC 患者的影响。
从 2010 年至 2016 年提取 SEER 数据。采用 Kaplan-Meier 分析比较 2001 年至 2016 年诊断的 MBC 患者的乳腺癌特异性生存（BCSS）。组间进行多变量 Cox 比例模型分析。采用 PSM 进行 1:1 病例对照匹配。
共纳入 1887 例患者，中位随访时间为 28 个月（范围 1-83 个月）。1749 例（92.7%）和 138 例（7.3%）患者 HER2 阴性组和 HER2 阳性组。833 例（44.1%）患者接受了乳房切除术放疗（PMRT）。HER2 阳性组患者年龄较小，肿瘤分级较低，肿瘤分期较晚。多变量 Cox 分析显示，预后与诊断时的年龄、种族/民族、TNM 分期和 PMRT 有关。ER 状态和 HER2 状态与 BCSS 无关。Kaplan-Meier 分析显示，PMRT 与较好的预后相关。重要的是，HER2 阴性状态的患者可以从 PMRT 中获益，但 HER2 阳性状态的患者不能获益。PSM 后多变量 Cox 分析显示，预后与 HER2 状态和 PMRT 有关。Kaplan-Meier 分析显示，PMRT 与 HER2 阴性患者的预后较好有关。
我们的研究结果支持 PMRT 和 HER2 阳性状态与 PSM 后较好的预后相关。然而，HER2 阴性但不是 HER2 阳性的患者可以从 PMRT 中获益。
