Ki-67指数为早期HER2低阳性乳腺癌提供长期生存信息：单机构回顾性分析
Ki-67 Index Provides Long-Term Survival Information for Early-Stage HER2-Low-Positive Breast Cancer: A Single-Institute Retrospective Analysis.
作者信息
Qi Wei-Xiang, Chen Lingyan, Cao Lu, Xu Cheng, Cai Gang, Chen Jiayi
机构信息
Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
J Oncol. 2022 Sep 13;2022:4364151. doi: 10.1155/2022/4364151. eCollection 2022.
AIM
It has been reported that more than half of breast cancer (BC) could be identified as HER2-low-positive, which might be a distinct subtype. But the results are controversial. We aim to compare the survival outcomes between HER2-low-positive and HER2-0 BC with Asian women based on HR status or Ki-67 index.
METHODS
Between January 2009 and December 2017, HER2-nonamplified BC in our single institute was identified. Patients were classified as HER2-low and HER2-0 cohort. Clinical characteristics were compared between these two groups and survival outcomes were calculated by the Kaplan-Meier method. We also performed subgroup analysis according to Ki-67 index and hormone-receptor (HR) status.
RESULTS
Of the 2,230 included patients, 536 presented with HER2-0, and 1,694 with HER2-low positive. After a median follow-up of 85 months (range: 1-152 months), the 8-year OS, BCSS, and RFS of the overall cohort were 91%, 95%, and 89%, respectively. In comparison with the HER2-0 cohort, majority of HER2-low-expression BC concurrently presented with HR positive (82.3% vs. 69%, < 0.001). There was no significant survival difference between the two groups in terms of OS, BCSS, and RFS (all > 0.05). We then performed subgroup analysis according to HR status and Ki-67 index (<14% vs. ≥14%). Our results indicated that there was no significant survival difference between HER2-low-positive and HER2-0 tumors regardless of HR status ( > 0.05), while OS (=0.026) and BCSS (=0.052) of HER2-0 BC with high Ki-67 index were significantly poorer than that of HER2-low positive with high Ki-67, but not for RFS (=0.17).
CONCLUSION
Among early stage HER2-nonamplified BC, no significant survival difference could be found between HER2-low positive and HER2-0 cohort regardless of HR status. Survival outcomes of HER2-low positive with high Ki-67 seem to be poorer than that of HER2-0 tumors with high Ki-67 index.
目的
据报道，超过半数的乳腺癌（BC）可被鉴定为HER2低表达阳性，这可能是一种独特的亚型。但结果存在争议。我们旨在基于HR状态或Ki-67指数比较亚洲女性中HER2低表达阳性和HER2零表达BC之间的生存结果。
方法
2009年1月至2017年12月期间，在我们单中心研究所中识别出HER2非扩增型BC。患者被分为HER2低表达组和HER2零表达组。比较两组的临床特征，并采用Kaplan-Meier法计算生存结果。我们还根据Ki-67指数和激素受体（HR）状态进行了亚组分析。
结果
在纳入的2230例患者中，536例为HER2零表达，1694例为HER2低表达阳性。中位随访85个月（范围：1 - 152个月）后，整个队列的8年总生存率（OS）、无乳腺癌生存率（BCSS）和无复发生存率（RFS）分别为91%、95%和89%。与HER2零表达组相比，大多数HER2低表达BC同时为HR阳性（82.3%对69%，P < 0.001）。两组在OS、BCSS和RFS方面无显著生存差异（均P > 0.05）。然后我们根据HR状态和Ki-67指数（<14%对≥14%）进行亚组分析。我们的结果表明，无论HR状态如何，HER2低表达阳性和HER2零表达肿瘤之间无显著生存差异（P > 0.05），而Ki-67指数高的HER2零表达BC的OS（P = 0.026）和BCSS（P = 0.052）显著低于Ki-67指数高的HER2低表达阳性，但RFS无差异（P = 0.17）。
结论
在早期HER2非扩增型BC中，无论HR状态如何，HER2低表达阳性和HER2零表达组之间未发现显著生存差异。Ki-67指数高的HER2低表达阳性的生存结果似乎比Ki-67指数高的HER2零表达肿瘤更差。
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