摘要： 目的 探讨人表皮生长因子受体2（HER2）低表达患者的临床病理特征及其预后影响因素。方法 收集大连医科大学附属第一医院2012年1月1日至2021年12月31日期间收治的原发性早期乳腺癌病例，共1772例，其中859例为HER2低表达乳腺癌，对比HER2低表达患者与总人群间的临床病理特征差异及预后情况，并通过构建Cox比例风险回归模型分析HER2低表达患者的预后影响因素。结果 与总体乳腺癌患者相比，HER2低表达患者肿瘤组织学分级多为Ⅱ级（P=0.036）、激素受体（HR）阳性表达比例更高（P<0.0001）。N₂和N₃较N₀（P=0.002，P=0.001）、脉管癌栓（P=0.017）、HR阳性（P=0.0001）、Ki-67表达>14%~30%阳性者较≤14%者（P=0.012）对于HER2低表达患者总生存期（OS）的影响具有统计学意义。且N₂和N₃相对于N₀（P=0.014，P=0.001）、脉管癌栓（P=0.001）、HR阳性（P=0.025）、CK5/6阳性（P=0.007）对于HER2低表达患者无病生存期（DFS）的影响也具有统计学意义。结论 HER2低表达患者具有组织学分级较低及HR阳性比例较高的特点。淋巴结转移、HR阳性及脉管癌栓是早期HER2低表达乳腺癌患者OS及DFS的独立影响因素。

HER2低表达乳腺癌的临床病理特征和预后因素分析

白冰, 张艾佳, 郭新, 王洪江, 王娅

大连医科大学附属第一医院乳腺外科, 辽宁大连 116011

收稿日期:2022-09-23出版日期:2023-06-30发布日期:2023-05-31
通讯作者:王娅E-mail:13478616227@163.com
作者简介:白冰（1996-），男，医师，硕士
基金资助:吴阶平医学基金会临床科研专项（320.6750.2022-19-50）


关键词: 人表皮生长因子受体2, 乳腺癌, 临床病理特征, 预后
Abstract: Objective To analyze the clinicopathological characteristics of patients with low HER2 expression and explore the prognostic factors. Methods Data was collected from 1 772 patients with primary early breast cancer who were admitted to The First Affiliated Hospital of Dalian Medical University from Jan 1,2012 to Dec 31,2021,of which 859 had low HER2 expression. The differences in the clinicopathological characteristics and prognosis of the patients with and without low HER2 were analyzed and a Cox proportional hazards regression model was constructed to explore the prognostic risk factors of HER2 low patients. Results The HER2 low patients had a higher number of histological gradeⅡtumors (P=0.036),and a higher proportion of positive hormone receptor (HR) expression (P < 0.000 1). N₂ and N₃ relative to N₀(P=0.002;P=0.001),vascular tumor thrombus (P=0.017),HR positive (P=0.000 1), Ki-67 expression 14% to 30% versus ≤ 14% (P=0.012) all had a statistically significant effects on OS in HER2 low patients. N₂ and N₃ compared with N₀(P=0.014;P=0.001),vascular tumor thrombus (P=0.001),HR positive (P=0.025),and CK5/6 positive (P=0.007) all had a statistically significant effect on DFS in HER2 low patients. Conclusion Patients with low HER2 expression had lower histological grades and a higher proportion of HR positivity. Lymph node metastasis,hormone receptor status,and vascular tumor thrombus were independent risk factors for OS and DFS in patients with early HER2 low breast cancer.
Key words: human epidermal growth factor receptor 2, breast cancer, clinicopathologic feature, prognosis
PDF全文下载地址:

https://journal.cmu.edu.cn/CN/article/downloadArticleFile.do?attachType=PDF&id=3224