早期人表皮生长因子受体 2（HER2）低表达乳腺癌的临床病理特征及预后因素分析：与 HER2-0 乳腺癌相比。
Analysis of clinicopathological characteristics and prognostic factors of early-stage human epidermal growth factor receptor 2 (HER2)-low breast cancer: Compared with HER2-0 breast cancer.
机构信息
Thyroid and Breast Surgery, Peking University First Hospital, Beijing, China.
Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
出版信息
Cancer Med. 2023 Oct;12(19):19560-19575. doi: 10.1002/cam4.6571. Epub 2023 Sep 29.
PURPOSE
To investigate the clinicopathological characteristics and prognostic factors of early-stage breast cancer (EBC) with human epidermal growth factor receptor 2 (HER2)-low expression.
METHODS
The clinicopathological data and follow-up information of EBC patients with HER2-low and HER2-0 expression treated at the Breast Disease Center of Peking University First Hospital from January 2014 to December 2017 were analyzed. The prognosis between HER2-low and HER2-0 expression groups and with different hormone receptor (HR) expression were compared by statistics. Meanwhile, the expression of Ki67, androgen receptor (AR), TOPIIa, P53, PTEN, and CK5/6 were also analyzed with the HER2-low expression and prognosis.
RESULTS
Retrospectively analyzed 1253 cases of EBC, including 583 (46.5%) cases of HER2-low breast cancer (BC) and 366 (29.2%) HER2-0 BC cases. Among the HER2-low BC patients, 487 (83.5%) were HR-positive, while 96 (16.5%) were HR-negative. Among the HER2-0 BC patients, 265 (72.4%) were HR-positive, while 101 (27.6%) were HR-negative. Median follow-up time was 53 months. The 5-year disease-free survival of HER2-low BC patients was 90.2% (95% confidence interval [CI]: 87.2-93.1), and the 5-year overall survival was 95.4% (95% CI: 93.3-97.6). Cox regression analysis showed that T stage, lymphovascular invasion, and/or perineural invasion were prognostic factors of HER2-low BC patients. However, the 5-year disease-free survival and overall survival of patients in the HER2-low and HER2-0 groups were not significantly different in all patients, but a tendency of better prognosis in HER2-low group was seen in HR-negative tumors.
CONCLUSION
HER2-low EBC patients accounted for 46.5% of the patient population. T stage, lymphovascular invasion, and/or perineural invasion were factors affecting the prognosis of BC patients with low HER2 expression. No significant difference in prognosis was noted between HER2-low and HER2-0 EBC patients. But in HR-negative tumors, a tendency of better prognosis was seen in HER2-low versus HER2-0.
目的
探讨人表皮生长因子受体 2（HER2）低表达的早期乳腺癌（EBC）的临床病理特征和预后因素。
方法
分析 2014 年 1 月至 2017 年 12 月在北京大学第一医院乳腺疾病中心接受治疗的 HER2 低表达和 HER2-0 表达的 EBC 患者的临床病理资料和随访信息。通过统计学比较 HER2 低表达和 HER2-0 表达组以及不同激素受体（HR）表达组之间的预后差异。同时，还分析了 HER2 低表达与预后相关的 Ki67、雄激素受体（AR）、拓扑异构酶 IIα（TOPIIa）、P53、PTEN 和 CK5/6 的表达。
结果
回顾性分析了 1253 例 EBC 患者，其中 583 例（46.5%）为 HER2 低乳腺癌（BC）患者，366 例（29.2%）为 HER2-0 BC 患者。在 HER2 低 BC 患者中，487 例（83.5%）为 HR 阳性，96 例（16.5%）为 HR 阴性。在 HER2-0 BC 患者中，265 例（72.4%）为 HR 阳性，101 例（27.6%）为 HR 阴性。中位随访时间为 53 个月。HER2 低 BC 患者的 5 年无病生存率为 90.2%（95%置信区间 [CI]：87.2-93.1），5 年总生存率为 95.4%（95% CI：93.3-97.6）。Cox 回归分析显示，T 分期、脉管瘤栓和/或神经周围侵犯是 HER2 低 BC 患者的预后因素。然而，在所有患者中，HER2 低组和 HER2-0 组患者的 5 年无病生存率和总生存率均无显著差异，但在 HR 阴性肿瘤中，HER2 低组的预后有更好的趋势。
结论
HER2 低表达的 EBC 患者占患者人群的 46.5%。T 分期、脉管瘤栓和/或神经周围侵犯是影响 HER2 低表达 BC 患者预后的因素。HER2 低表达和 HER2-0 EBC 患者的预后无显著差异。但在 HR 阴性肿瘤中，HER2 低组与 HER2-0 组相比，预后更好。
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