早期乳腺癌患者HER2低表达的临床病理特征及预后意义：一项系统评价和Meta分析
Clinicopathologic characteristics and prognostic significance of HER2-low expression in patients with early breast cancer: A systematic review and meta-analysis.
作者信息
Wei Tong, Wang Dingyuan, Gao Songlin, Wang Xue, Yue Jian, Kang Yikun, Ju Jie, Yang Zixuan, Shuai You, Yuan Peng
机构信息
Department of VIP Medical, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Front Oncol. 2023 Feb 2;13:1100332. doi: 10.3389/fonc.2023.1100332. eCollection 2023.
BACKGROUND
HER2-low expression breast cancer (BC) accounts for approximately 45%-55% of all BC cases. The purpose of this study was to investigate the prognostic difference between patients with HER2-low expression and HER2-zero BC.
METHODS
An electronic search of Pubmed, Embase, Cochrane Library, and Web of Science databases was performed to screen studies that included prognostic comparisons between HER2-zero and HER2-low expression groups. A total of 14 studies involving 52106 patients were included.
RESULTS
Our results indicated that HER2-low expression was associated with a significant benefit in OS among all patients with early BC (HR, 0.83; 95% CI, 0.78-0.88), patients with hormone-receptor positive BC (HR, 0.83; 95% CI, 0.77-0.89), and patients with TNBC (HR, 0.78; 95% CI, 0.70-0.87). HER2-low expression was associated with a significant benefit in DFS among all patients (HR, 0.81; 95% CI, 0.71-0.93), patients with hormone receptor-positive BC (HR, 0.81; 95% CI, 0.72-0.90), but no significant difference in DFS was found in patients with TNBC (HR, 0.87; 95% CI, 0.65-1.17). HER2-low expression was associated with a significant benefit in RFS among all patients (HR, 0.90; 95% CI, 0.85-0.95), patients with hormone receptor-positive BC (HR, 0.90; 95% CI, 0.84-0.96), but no significant difference in RFS was found in patients with TNBC (HR, 0.80; 95% CI, 0.55-1.16).
CONCLUSIONS
Among patients with early-stage BC, patients with HER2-low expression BC had better OS in the overall population, hormone receptor-positive and TNBC subgroups. Besides, favorable DFS and RFS were observed in both the overall population and hormone receptor-positive subgroup.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD 42022349458).
背景
HER2低表达乳腺癌（BC）约占所有BC病例的45%-55%。本研究的目的是调查HER2低表达患者与HER2零表达BC患者之间的预后差异。
方法
对PubMed、Embase、Cochrane图书馆和Web of Science数据库进行电子检索，以筛选包含HER2零表达组与HER2低表达组预后比较的研究。共纳入14项研究，涉及52106例患者。
结果
我们的结果表明，HER2低表达与所有早期BC患者（HR，0.83；95%CI，0.78-0.88）、激素受体阳性BC患者（HR，0.83；95%CI，0.77-0.89）和三阴性乳腺癌（TNBC）患者（HR，0.78；95%CI，0.70-0.87）的总生存期（OS）显著获益相关。HER2低表达与所有患者（HR，0.81；95%CI，0.71-0.93）、激素受体阳性BC患者（HR，0.81；95%CI，0.72-0.90）的无病生存期（DFS）显著获益相关，但TNBC患者的DFS无显著差异（HR，0.87；95%CI，0.65-1.17）。HER2低表达与所有患者（HR，0.90；95%CI，0.85-0.95）、激素受体阳性BC患者（HR，0.90；95%CI，0.84-0.96）的复发-free生存期（RFS）显著获益相关，但TNBC患者的RFS无显著差异（HR，0.80；95%CI，0.55-1.16）。
结论
在早期BC患者中，HER2低表达BC患者在总体人群、激素受体阳性和TNBC亚组中的OS更好。此外，在总体人群和激素受体阳性亚组中均观察到良好的DFS和RFS。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/，标识符（CRD 42022349458）。
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