Department of Women's Health, Tübingen University, 72076 Tübingen, Germany.
Department for Gynecology and Obstetrics, Freiburg University, 79085 Freiburg im Breisgau, Germany.
Int J Mol Sci. 2024 May 29;25(11):5910. doi: 10.3390/ijms25115910.
Breast cancer remains a leading cause of cancer mortality in women globally. Despite advancements in systemic therapy, the risk of distant recurrence persists even after such treatment and may be linked to disseminated tumor cells (DTCs). Variability in molecular characteristics between primary tumors (PTs) and distant metastases underscores the need to comprehensively understand metastatic pathways. This retrospective study investigated discrepancies between HER2 expression in PTs and DTCs and their implications for survival outcomes in 201 early breast cancer (EBC) patients. We found a significant association between HER2 expression in PTs and DTCs when classifying tumors as HER2-high/low/negative. Patients whose HER2 status was discordant between PTs and DTCs exhibited worse distant disease-free survival than those with concordant status. Multivariate analysis confirmed the HER2 status of DTCs as an independent prognostic factor for distant DFS. These findings emphasize the importance of assessing HER2 expression in DTCs and its potential implications for tailored therapy strategies in EBC. Furthermore, prospective trials are needed to validate these findings and explore targeted therapies based on the molecular characteristics of DTCs.
乳腺癌仍然是全球女性癌症死亡的主要原因。尽管在系统治疗方面取得了进展，但即使经过这种治疗，远处复发的风险仍然存在，并且可能与播散的肿瘤细胞（DTCs）有关。原发肿瘤（PTs）和远处转移之间分子特征的可变性强调了全面了解转移途径的必要性。这项回顾性研究调查了 201 例早期乳腺癌（EBC）患者中 PT 和 DTC 中 HER2 表达的差异及其对生存结果的影响。当将肿瘤分类为 HER2-高/低/阴性时，我们发现 PT 和 DTC 中 HER2 表达之间存在显著相关性。PT 和 DTC 之间 HER2 状态不一致的患者远处无病生存率比状态一致的患者差。多变量分析证实 DTC 的 HER2 状态是远处无复发生存的独立预后因素。这些发现强调了评估 DTC 中 HER2 表达及其对 EBC 个体化治疗策略的潜在影响的重要性。此外，需要前瞻性试验来验证这些发现，并根据 DTC 的分子特征探索靶向治疗。
