Department of Pathology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, P. R. China.
Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'an Road, Shanghai, 200032, P. R. China.
BMC Cancer. 2023 Jan 25;23(1):84. doi: 10.1186/s12885-023-10531-z.
Breast cancer patients of American Society of Clinical Oncology and the College of American Pathologists (ASCO/CAP) Group 2 were all HER2-negative according to the 2018 guideline, not HER2-positive as defined in the 2013 guideline.
We aims to elucidate the unique clinicopathological features of ASCO/CAP Group 2 patients by comparing with classic HER2-nonamplified cancers, and reveal the efficacy of the former to anti-HER2 therapy. The clinicopathological features, treatment and prognosis information of 99 patients between 2014 and 2018 were collected. HER2 status was re-defined using the updated recommendations.
Of the 99 ASCO/CAP Group 2 tumors, 25.5% (25/99) tumors were immunohistochemical (IHC) 0/1+ and 74.7% (74/99) tumors were IHC 2+. According to the updated 2018 guideline, all of them were HER2 negative. When compared to ASCO/CAP Group 5, patients of ASCO/CAP Group 2 displayed higher ratio of histological grade 3 (P = .03), high Ki67 proliferation index (P = .03) and pN3 (more than 9 lymph nodes metastasis, P = .02), and lower estrogen receptor (ER) positivity (P = .04). There was no statistical difference in the survival of patients received anti-HER2 therapy and patients not received anti-HER2 therapy.
Patients of ASCO/CAP Group 2 did not received apparent benefit from anti-HER2 treatment. Although according to the updated guidelines and latest reports, HER2 is negative, but when compared with classic HER2-nonamplified cancers, patients of this group seemed to be more aggressive. We suggest that this group still be regarded as an independent category, in order to accumulate more cases in the future to expand the scope of research.
根据 2018 年指南，美国临床肿瘤学会和美国病理学家协会（ASCO/CAP）Group 2 的乳腺癌患者均为 HER2 阴性，与 2013 年指南定义的 HER2 阳性不同。
我们旨在通过与经典的 HER2 无扩增癌进行比较，阐明 ASCO/CAP Group 2 患者的独特临床病理特征，并揭示前者对抗 HER2 治疗的疗效。收集了 2014 年至 2018 年 99 例患者的临床病理特征、治疗和预后信息。使用更新的建议重新定义 HER2 状态。
在 99 例 ASCO/CAP Group 2 肿瘤中，25.5%（25/99）肿瘤的免疫组化（IHC）为 0/1+，74.7%（74/99）肿瘤的 IHC 为 2+。根据更新的 2018 年指南，所有肿瘤均为 HER2 阴性。与 ASCO/CAP Group 5 相比，ASCO/CAP Group 2 患者的组织学分级 3 比例更高（P=.03），Ki67 增殖指数更高（P=.03），pN3（淋巴结转移超过 9 个，P=.02）更多，雌激素受体（ER）阳性率更低（P=.04）。接受抗 HER2 治疗和未接受抗 HER2 治疗的患者的生存无统计学差异。
ASCO/CAP Group 2 的患者并未从抗 HER2 治疗中获得明显获益。尽管根据更新的指南和最新报告，HER2 为阴性，但与经典的 HER2 无扩增癌相比，该组患者似乎更具侵袭性。我们建议将该组仍视为一个独立的类别，以便在未来积累更多病例来扩大研究范围。
