Révillion F, Bonneterre J, Peyrat J P
Laboratoire d'Oncologie Moléculaire Humaine, Centre Oscar Lambret, Lille, France.
Eur J Cancer. 1998 May;34(6):791-808. doi: 10.1016/s0959-8049(97)10157-5.
We reveiwed the relationships between ERBB2 amplification and/or overexpression in human breast cancer and the clinicopathological parameters described in the literature (97 studies involving 22,616 patients) in order to draw conclusions regarding its clinical interest. The mean of ERBB2 positivity (26%, ranging from 5 to 55%) is not dependent on the method used to evaluate ERBB2 amplification or overexpression. Despite the discrepancies observed between the different studies, several associations between ERBB2 positivity and the classical clinicopathological parameters were noted. There are clear relationships between ERBB2 positivity and the lack of steroid receptors, the histological subtypes of mammary tumours (ductal invasive and in situ), worse histological and nuclear grades, aneuploidy and high rate of proliferation. In univariate analyses, ERBB2 is strongly associated with poor prognosis. All these data indicate that ERBB2 is a marker of aggressiveness of the tumour. However, ERBB2 does not retain a clinical prognostic significance in multivariate analyses, since it is associated with several strong prognostic parameters. When considering the prognostic value of ERBB2 in relation to treatment, a significantly worse survival of the treated patients is noted in ERBB2 positive patients. This suggest that ERBB2 could be a marker of reduced response to chemotherapy and hormonal treatment. With respect to the tumour response to treatment, the results, provided as yet by pilot studies, remain controversial and further investigations are necessary to evaluate the predictive value of ERBB2. Finally, new therapeutic approaches targeting the cells overexpressing ERBB2 have been developed.
我们回顾了人乳腺癌中ERBB2扩增和/或过表达与文献中描述的临床病理参数之间的关系（97项研究，涉及22,616名患者），以便得出关于其临床意义的结论。ERBB2阳性的平均值（26%，范围为5%至55%）不取决于用于评估ERBB2扩增或过表达的方法。尽管不同研究之间存在差异，但仍注意到ERBB2阳性与经典临床病理参数之间的一些关联。ERBB2阳性与缺乏类固醇受体、乳腺肿瘤的组织学亚型（浸润性导管癌和原位癌）、较差的组织学和核分级、非整倍体以及高增殖率之间存在明确的关系。在单变量分析中，ERBB2与预后不良密切相关。所有这些数据表明，ERBB2是肿瘤侵袭性的标志物。然而，在多变量分析中，ERBB2不具有临床预后意义，因为它与几个强有力的预后参数相关。当考虑ERBB2与治疗相关的预后价值时，ERBB2阳性患者经治疗后的生存率明显更差。这表明ERBB2可能是化疗和激素治疗反应降低的标志物。关于肿瘤对治疗的反应，目前试点研究提供的结果仍存在争议，需要进一步研究来评估ERBB2的预测价值。最后，已经开发出针对过表达ERBB2细胞的新治疗方法。
