摘要： 目的 探讨HER-2低表达的三阴性乳腺癌患者临床特征和预后。方法 收集我院2015年1月至2019年1月收治的三阴性乳腺癌患者498例, 根据患者HER-2表达情况, 将患者分为阴性组(免疫组化HER-2为0) 和低表达组(免疫组化HER-2为1+, 或者HER-2为2+但Fish检测显示HER-2基因未扩增), 比较2组患者临床特征、术后复发率或转移率。采用生存曲线比较2组患者的无病生存率。结果 与阴性组比较, 低表达组患者Ki-67显著增高(66.47%±16.38% vs. 54.37%±15.82%,P < 0.001); T分期为T₃的患者比例显著增高(28.38% vs. 14.86%,P < 0.001); 淋巴结转移率显著增高(35.14% vs. 25.71%,P=0.033); 腋窝淋巴结清扫率显著增高(52.70% vs. 36.00%,P=0.001); 术后3年内复发或转移率显著增高(10.81% vs. 5.14%,P=0.022)。与阴性组比较, 低表达组患者无病生存率显著降低(P=0.019)。logistic回归分析显示HER-2低表达是三阴性乳腺癌患者术后3年复发或转移的危险因素(OR=1.453, 95%CI:1.008~2.912)。结论 HER-2低表达的三阴性乳腺癌患者临床特征与HER-2不表达的患者显著不同,HER-2低表达是三阴性乳腺癌患者术后复发或转移的危险因素, 无病生存率较低。

HER-2低表达的三阴性乳腺癌患者的临床特征和预后分析

于宏, 邱芳, 顾玺, 边小博

中国医科大学附属盛京医院肿瘤中心, 沈阳 110004

收稿日期:2022-02-12出版日期:2022-08-30发布日期:2022-07-19
通讯作者:邱芳E-mail:roseqiufang@163.com
作者简介:于宏（1992-），女，主治医师，硕士.
基金资助:辽宁省自然科学基金（2020-MS-178）


关键词: 人表皮生长因子受体2, 三阴性乳腺癌, 临床特征, 预后
Abstract: Objective To investigate the clinical features and prognosis of patients with triple negative breast cancer with low expression of human epidermal growth factor receptor 2(HER-2). Methods Data was retrospectively collected from 498 patients with triple negative breast cancer who were admitted to our hospital between January 2015 and January 2019. According to their HER-2 expression status, the patients were divided into a negative group(immunohistochemistry:HER-2 0) and a low expression group(immunohistochemistry HER-2:1+, or HER-2 2+, but ISH test showed that the HER-2 gene not amplified). Clinical characteristics and postoperative recurrence rate or metastasis rate of both groups were compared. Results Compared to the negative group, Ki-67 in the low expression group was significantly higher(66.47%±16.38% vs. 54.37%±15.82%,P < 0.001); the proportion of patients with T₃ was significantly higher(28.38% vs. 14.86%,P < 0.001); the rate of lymph node metastasis was significantly higher(35.14% vs. 25.71%,P=0.033); the axillary lymph node dissection rate was significantly increased(52.70% vs. 36.00%,P=0.001); The recurrence or metastasis rate increased significantly within 3 years postoperatively(10.81% vs. 5.14%,P=0.022). Compared to the negative group, the disease-free survival rate of patients in the low expression group was significantly lower(P=0.019). Logistic regression analysis showed that low expression of HER-2 was a risk factor for recurrence or metastasis in patients with triple negative breast cancer within 3 years postoperatively(OR=1.453, 95% CI:1.008-2.912). Conclusion The clinical characteristics of patients with triple negative breast cancer with low expression of HER-2 are significantly different from that of those with HER-2-zero. Low HER-2 expression is a risk factor for recurrence or metastasis in patients with triple negative breast cancer. Furthermore, the disease-free survival rate of patients in the low expression group was significantly lower.
Key words: human epidermal growth factor receptor 2, triple negative breast cancer, clinical features, prognosis
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