Huang Man, Jin Yudi, Wang Mengyuan, Song Qiang, Fan Yanjia, Zhang Yu, Tian Cheng, Zhang Chi, Liu Shengchun
Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Department of Breast Center, Chongqing University Three Gorges Hospital, Chongqing, People's Republic of China.
Breast Cancer (Dove Med Press). 2024 Oct 10;16:667-678. doi: 10.2147/BCTT.S478110. eCollection 2024.
HER2-low breast cancer represents a distinct subgroup with unique clinical characteristics and treatment challenges. Nevertheless, it remains uncertain whether there exists a distinction in δKi67 between patients with HER2-low and HER2-zero statuses, and whether the prognosis varies among patients with differing HER2 statuses and δKi67.
We conducted a multi-center retrospective study to investigate the correlation between alterations in Ki67 index following NAC and the prognosis among patients with HER2-low or HER2-zero breast cancer. 3 distinct cohorts comprising patients with HER2-negative breast cancer who underwent NAC were included. Comprehensive clinicopathological data were documented, with particular emphasis on evaluating changes in Ki67 index from baseline to post-NAC. These changes were then correlated with disease-free survival (DFS) through rigorous analysis.
Three cohorts, comprising 403, 315, and 72 patients respectively, were finally included. The study found that δKi67 did not show significant associations with other variables and were not identified as independent risk factors for survival. Nevertheless, across the three cohorts, following NAC, HER2-low breast cancer patients with δKi67 below the cut-off value demonstrated a better prognosis compared to those with δKi67 above the cut-off value. Additionally, their prognosis was also superior to that of HER2-zero breast cancer patients with δKi67 below the cut-off value.
Our study demonstrates that HER2-low breast cancer patients with δKi67 values below the cut-off point after NAC are associated with improved prognosis. Monitoring δKi67 index and HER2 status may help identify patients who are likely to benefit from NAC and guide personalized treatment strategies.
HER2低表达乳腺癌是一个具有独特临床特征和治疗挑战的不同亚组。然而，HER2低表达和HER2零表达患者之间的δKi67是否存在差异，以及不同HER2状态和δKi67的患者预后是否不同仍不确定。
我们进行了一项多中心回顾性研究，以调查新辅助化疗（NAC）后Ki67指数变化与HER2低表达或HER2零表达乳腺癌患者预后之间的相关性。纳入了3个不同队列，包括接受NAC的HER2阴性乳腺癌患者。记录了全面的临床病理数据，特别强调评估从基线到NAC后的Ki67指数变化。然后通过严格分析将这些变化与无病生存期（DFS）相关联。
最终纳入了3个队列，分别有403、315和72名患者。研究发现，δKi67与其他变量无显著关联，未被确定为生存的独立危险因素。然而，在这3个队列中，NAC后δKi67低于临界值的HER2低表达乳腺癌患者与δKi67高于临界值的患者相比，预后更好。此外，他们的预后也优于δKi67低于临界值的HER2零表达乳腺癌患者。
我们的研究表明，NAC后δKi67值低于临界点的HER2低表达乳腺癌患者预后改善。监测δKi67指数和HER2状态可能有助于识别可能从NAC中获益的患者，并指导个性化治疗策略。
