Tanaka Namiko, Imanishi Seiichi, Takeuchi Chisato, Goto Takayoshi, Kittaka Nobuyoshi
Department of Breast Surgery, Osaka Rosai Hospital, Osaka, JPN.
Department of Diagnostic Pathology, Osaka International Medical & Science Center, Osaka, JPN.
Cureus. 2024 Nov 27;16(11):e74561. doi: 10.7759/cureus.74561. eCollection 2024 Nov.
Background This study aimed to evaluate the relationship among human epidermal growth factor receptor 2 (HER2) expression level, pathological complete response (pCR) rate of neoadjuvant chemotherapy, and prognosis in early-stage triple-negative breast cancer (TNBC). Methodology This retrospective study analyzed the relationship among HER2 expression level, pCR rate, clinicopathological factors, and prognosis in 39 patients who were diagnosed with TNBC between 2012 and 2020 at Osaka Rosai Hospital and underwent surgery after neoadjuvant chemotherapy (NAC). Results Patients' age ranged 33-86 (median = 57) years, and the observation period ranged 5-130 (median = 60) months. The HER2 expression levels were HER2 (0), HER2 (1+), and HER2 (2+, fluorescence in situ hybridization test (FISH); negative) for 18, 12, and 9 cases, respectively. The pCR rates were 38.9%, 8.3%, and 44.4% for HER2 (0), HER2 (1+), and HER2 (2+, FISH; negative), respectively, and no correlation was observed with the degree of HER2 expression. The prognosis of distant disease-free survival (DDFS) differed depending on the HER2 status (p = 0.032), and this trend was also observed in overall survival (OS) (p = 0.012). This tendency became even stronger when comparing HER2-low and HER2 (0) (p = 0.028 and p = 0.01, respectively). HER2 expression was significantly decreased from before to after NAC (p = 0.001). Conclusions HER2 expression did not correlate with the pCR rate of NAC but did correlate with DDFS and OS. Thus, patients with an HER2 (0) status are considered to have a poor prognosis and should be more aggressively considered for perioperative chemotherapy, e.g., immune checkpoint inhibitors.
背景 本研究旨在评估人表皮生长因子受体2（HER2）表达水平、新辅助化疗的病理完全缓解（pCR）率与早期三阴性乳腺癌（TNBC）预后之间的关系。方法 这项回顾性研究分析了2012年至2020年期间在大阪罗赛医院被诊断为TNBC并在新辅助化疗（NAC）后接受手术的39例患者中HER2表达水平、pCR率、临床病理因素和预后之间的关系。结果 患者年龄在33 - 86岁（中位数 = 57岁）之间，观察期在5 - 130个月（中位数 = 60个月）之间。HER2表达水平分别为HER2（0）18例、HER2（1+）12例、HER2（2+，荧光原位杂交检测（FISH）；阴性）9例。HER2（0）、HER2（1+）和HER2（2+，FISH；阴性）的pCR率分别为38.9%、8.3%和44.4%，且未观察到与HER2表达程度相关。远处无病生存（DDFS）的预后因HER2状态而异（p = 0.032），总生存（OS）中也观察到这种趋势（p = 0.012）。当比较HER2低表达和HER2（0）时，这种趋势更加明显（分别为p = 0.028和p = 0.01）。HER2表达在NAC前后显著降低（p = 0.001）。结论 HER2表达与NAC的pCR率无关，但与DDFS和OS相关。因此，HER2（0）状态的患者被认为预后较差，应更积极地考虑围手术期化疗，如免疫检查点抑制剂。
