Huang Xiaochen, Li Shaoqiu, Yang Tingting, Ma Dawei, Cai Hongzhou, Xu Xinyu, Zhang Yi
Department of Pathology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Department of Urology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Transl Androl Urol. 2024 Nov 30;13(11):2419-2429. doi: 10.21037/tau-24-354. Epub 2024 Nov 28.
Some urothelial carcinoma patients are ineligible for platinum-based chemotherapy, necessitating exploration of other effective therapeutic strategies. Human epidermal growth factor receptor 2 (HER2) protein overexpression, gene amplification or mutations exist in urothelial carcinoma. Our study is to investigate the correlation of three-tier assessment of HER2 expression with clinical pathological characteristics and prognosis of urothelial carcinoma.
HER2 expression in 75 urothelial carcinomas from Jiangsu Cancer Hospital was re-scored by immunohistochemistry and fluorescence in situ hybridization according to HER2 three-tier assessment standards. Its relationship with various pathological parameters of urothelial carcinoma and its correlation with prognosis were analyzed. And validate in The Cancer Genome Atlas (TCGA) cohort.
HER2 expression was observed in 82.7% (62/75) of urothelial carcinoma patients, of which HER2-low expression accounted for 61.3% (46/75). HER2 expression was significantly correlated with the tumor-nodes-metastasis (TNM) stage of urothelial carcinoma (P=0.043) and HER2-low was an independent poor prognostic factor for patients with urothelial carcinoma (P=0.04). Follow-up showed that HER2-low patients had the worst prognosis compared with HER2-negative (P=0.02) and HER2 positive (P=0.02) and also had the highest progression rate in TCGA cohort (P=0.02); receiver operator characteristic (ROC) model suggested HER2-low could effectively predict prognosis.
HER2 expression is closely related to the TNM stage of urothelial carcinoma; HER2 three-tier assessment can effectively predict clinical prognosis of urothelial carcinoma.
一些尿路上皮癌患者不符合铂类化疗条件，因此有必要探索其他有效的治疗策略。尿路上皮癌中存在人表皮生长因子受体2（HER2）蛋白过表达、基因扩增或突变。我们的研究旨在探讨HER2表达的三级评估与尿路上皮癌临床病理特征及预后的相关性。
根据HER2三级评估标准，对江苏省肿瘤医院75例尿路上皮癌组织中的HER2表达进行免疫组织化学和荧光原位杂交重新评分。分析其与尿路上皮癌各项病理参数的关系及其与预后的相关性，并在癌症基因组图谱（TCGA）队列中进行验证。
75例尿路上皮癌患者中82.7%（62/75）检测到HER2表达，其中HER2低表达占61.3%（46/75）。HER2表达与尿路上皮癌的肿瘤-淋巴结-转移（TNM）分期显著相关（P=0.043），HER2低表达是尿路上皮癌患者独立的不良预后因素（P=0.04）。随访显示，HER2低表达患者的预后比HER2阴性（P=0.02）和HER2阳性（P=0.02）患者更差，且在TCGA队列中的进展率最高（P=0.02）；受试者工作特征（ROC）模型表明HER2低表达可有效预测预后。
HER2表达与尿路上皮癌的TNM分期密切相关；HER2三级评估可有效预测尿路上皮癌的临床预后。
