Cancer Research Center, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
ATMP Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, P.O. Box 1517964311, Tehran, Iran.
Sci Rep. 2023 Oct 4;13(1):16719. doi: 10.1038/s41598-023-43186-8.
HER2 is an important prognostic marker in breast cancer (BC) patients, which also plays a crucial role in their therapeutic plan. Consequently, a great desire is to thoroughly assess the patients based on their HER2 status. In the current study, we aimed to evaluate HER2-low breast cancer as a new subtype in the standard classification of BC patients and review its characteristics and survival rate in a tertiary center in Iran. We retrospectively evaluated disease-free survival (DFS), overall survival (OS), and clinicopathological characteristics of BC patients referred to the Cancer Research Center in Tehran, Iran from 1991 to 2022. Patients' clinical characteristics, including HER2 status, which is classified as HER2-low, HER2-positive, or HER2-negative, were obtained from prospectively maintained registries. Among the total 3582 recruited patients, 60.2%, 13.6%, and 26.2% were HER2-negative, HER2-low, and HER2-positive, respectively. HER2-positive patients showed a significantly higher Hazard Ratio (HR) for DFS (HR 1.44, 95% CI 1.01-2.05) and OS (HR 2.05, 95% CI 1.31-3.20), compared to HER2-low. Moreover, HER2-low and HER2-negative were found to show the same proportion of high-grade tumors (28 and 28.4%), while 40% of the HER2-positive tumors were high-grade. Accordingly, HER2-low patients had a lower metastasis risk than the others (P-value = 0.01). The Ki67 percentage was significantly lower in the HER2-low group compared to the HER2-positive (P-value < 0.001). HER2-low, a new subtype of HER2-status classification with distinct biological and clinicopathological traits, represented the highest survival rate and less invasive characteristics. This difference was statistically significant when compared to HER2-positive, but not when compared to HER2-negative.Research registration unique identifying number: NCT05754047.
HER2 是乳腺癌（BC）患者的重要预后标志物，在治疗计划中也起着至关重要的作用。因此，人们非常希望根据 HER2 状态对患者进行全面评估。在本研究中，我们旨在评估 HER2 低表达乳腺癌作为 BC 患者标准分类中的一个新亚型，并在伊朗的一家三级中心回顾其特征和生存率。我们回顾性评估了 1991 年至 2022 年期间到伊朗德黑兰癌症研究中心就诊的 BC 患者的无病生存率（DFS）、总生存率（OS）和临床病理特征。患者的临床特征，包括 HER2 状态，分为 HER2 低表达、HER2 阳性或 HER2 阴性，从前瞻性维护的登记处获得。在总共招募的 3582 名患者中，HER2 阴性、HER2 低表达和 HER2 阳性的比例分别为 60.2%、13.6%和 26.2%。与 HER2 低表达相比，HER2 阳性患者的 DFS（HR 1.44，95%CI 1.01-2.05）和 OS（HR 2.05，95%CI 1.31-3.20）的风险比（HR）显著更高。此外，HER2 低表达和 HER2 阴性患者的高级别肿瘤比例相同（28%和 28.4%），而 40%的 HER2 阳性肿瘤为高级别。因此，HER2 低表达患者的转移风险低于其他患者（P 值=0.01）。与 HER2 阳性相比，HER2 低表达组的 Ki67 百分比显著降低（P 值<0.001）。HER2 低表达是一种具有独特生物学和临床病理特征的新的 HER2 状态分类亚型，代表了最高的生存率和侵袭性较小的特征。与 HER2 阳性相比，这一差异具有统计学意义，但与 HER2 阴性相比则无统计学意义。
NCT05754047。
