Ortiz-Calderon Ivan A, Arias-Ruiz Luis Felipe, Dorantes-Heredia Rita, Ruiz-Morales Jose Manuel
Oncology Center, Hospital Medica Sur, Mexico City, Mexico.
Anatomical Pathology Department, Hospital Medica Sur, Mexico City, Mexico.
World J Oncol. 2025 Feb;16(1):51-58. doi: 10.14740/wjon1966. Epub 2024 Dec 31.
The prognosis for urothelial carcinoma remains poor, with limited therapeutic options, emphasizing the need for further research into targeted therapies. The prognostic and predictive significance of human epidermal growth factor receptor 2 (HER2) expression in urothelial carcinoma remains unclear, with previous studies reporting conflicting results.
We conducted a retrospective analysis of advanced urothelial carcinoma cases diagnosed between January 2017 and December 2022. HER2 status was prospectively determined using the Leica CB11 antibody on available biopsy specimens. Patient data, tumor characteristics, and survival outcomes were retrieved from hospital records for analysis.
Of the 84 patients initially identified with muscle-invasive disease, HER2 immunohistochemistry (IHC) was performed on 50 samples. Among these, 54% exhibited HER2 scores ≥ 1+, with 22% classified as HER2-positive (3+ score by IHC), 10% as equivocal (2+ score by IHC), and 22% as HER2-low (1+ score by IHC). The distribution of HER2 score ≥ 1+ tumors included 25.7% in the bladder, 20.0% in the renal pelvis, and none in the ureter. HER2-positive (3+ score by IHC) tumors were all histological grade 3. Among these patients, 13.4% presented with localized disease, 20% with locally advanced disease, and 50% with metastatic disease at the time of diagnosis. Notably, 42.8% of recurrent tumors originating from the renal pelvis and 62.5% of those from the bladder exhibited HER2 scores ≥ 1+. Among patients diagnosed with non-metastatic disease, 100% with renal pelvis tumors and 75% with bladder tumors experienced metastatic recurrence if they were HER2-positive (3+ score by IHC). The overall survival for HER2-negative patients was 31.0 months (95% confidence interval (CI): 15.29 - 66.70) compared to 13.0 months (95% CI: 7.32 - 18.68) in the HER2 score ≥ 1+ population (P = 0.0029).
In this cohort of Mexican patients with urothelial carcinoma, HER2 expression was observed in 54.4% of cases. HER2-positive (+3 by IHC) tumors were associated with higher histological grade and worse prognostic outcomes, including increased recurrence, progression, and mortality.
尿路上皮癌的预后仍然很差，治疗选择有限，这凸显了对靶向治疗进行进一步研究的必要性。人类表皮生长因子受体2（HER2）在尿路上皮癌中的表达的预后和预测意义仍不明确，先前的研究报告结果相互矛盾。
我们对2017年1月至2022年12月期间诊断的晚期尿路上皮癌病例进行了回顾性分析。使用徕卡CB11抗体对可用活检标本前瞻性地确定HER2状态。从医院记录中检索患者数据、肿瘤特征和生存结果进行分析。
在最初确定为肌层浸润性疾病的84例患者中，对50份样本进行了HER2免疫组织化学（IHC）检测。其中，54%的患者HER2评分≥1+，22%被归类为HER2阳性（IHC评分为3+），10%为可疑（IHC评分为2+），22%为HER2低表达（IHC评分为1+）。HER2评分≥1+的肿瘤分布情况为：膀胱肿瘤占25.7%，肾盂肿瘤占20.0%，输尿管肿瘤未出现此类情况。HER2阳性（IHC评分为3+）的肿瘤均为组织学3级。在这些患者中，13.4%在诊断时表现为局限性疾病，20%为局部晚期疾病，50%为转移性疾病。值得注意的是，起源于肾盂的复发肿瘤中有42.8%、起源于膀胱的复发肿瘤中有62.5%的HER2评分≥1+。在诊断为非转移性疾病的患者中，如果HER2阳性（IHC评分为3+），肾盂肿瘤患者100%、膀胱肿瘤患者75%会发生转移性复发。HER2阴性患者的总生存期为31.0个月（95%置信区间（CI）：15.29 - 66.70），而HER2评分≥1+人群的总生存期为13.0个月（95%CI：7.32 - 18.68）（P = 0.0029）。
在这组墨西哥尿路上皮癌患者中，54.4%的病例观察到HER2表达。HER2阳性（IHC评分为+3）肿瘤与更高的组织学分级和更差的预后结果相关，包括复发、进展和死亡率增加。
