摘要
目的探讨免疫组织化学染色(IHC)及荧光原位杂交(FISH)结果对人表皮生长因子受体2(HER2)阳性乳腺癌患者新辅助靶向疗效的预测意义。方法回顾性分析2019-01-01-2020-09-30安徽医科大学第二附属医院(21例)及空军军医大学附属西京医院(91例)合计112例HER2阳性非特殊类型浸润性乳腺癌术前新辅助治疗患者的临床病理资料,分析比较IHC与FISH检测结果及新辅助治疗前后患者年龄、雌激素受体(ER)、孕激素受体(PR)、新辅助化疗方案等其他临床病理因素与病理完全缓解(pCR)的关系。结果112例患者中达pCR 67例,未达pCR 45例。ER(χ^(2)=6.278,P=0.012)、PR(χ^(2)=7.099,P=0.008)及抗HER2治疗方案(χ^(2)=13.516,P<0.001)与pCR有关联。在FISH检测中,HER2/第17号染色体着丝粒(HER2/CEP17)比值(Z=-3.904,P<0.001)及HER2/细胞数比值(Z=-3.493,P<0.001)与pCR率有关联。在多因素回归分析中,调整ER、PR及抗HER2治疗方案因素,使用妥妥双靶方案抗HER2治疗患者的pCR率更高,OR=5.059,95%CI为2.052~12.468,P<0.001;ER阴性患者pCR率相对于阳性患者更高,OR=0.309,95%CI为0.131~0.724,P=0.007。结论IHC与FISH检测都是重要的乳腺癌HER2检测方法。对于IHC(2+)人群FISH检测HER2/CEP17比值高低对预测疗效有重要意义。激素受体情况和抗HER2治疗方案也是影响疗效的重要因素。
Objective To explore the predictive significance of the results of immunocytochemistry(IHC)and fluorescence in situ hybridization(FISH)in the neoadjuvant targeting efficacy of human epidermal growth factor receptor 2(HER2)positive breast cancer patients.Methods The clinical and pathological data of 112 HER2 positive nonspecial type invasive breast cancer patients with neoadjuvant targeted therapy in the Second Hospital of Anhui Medical university(21 cases)and Xijing Hospital of Air Force Military Medical University(91 cases)from January 1,2019 to September 30,2020 were retrospectively analyzed.The correlation between the results of IHC and FISH as well as other clinicopathological data including age,ER,PR,neoadjuvant chemotherapy regimen and pathological complete response(pCR)of neoadjuvant targeted therapy was analyzed.Results Among 112 patients,67 patients achieved pCR and 45 patients did not achieved pCR.ER(χ^(2)=6.278,P=0.012),PR(χ^(2)=7.099,P=0.008)and anti-HER2 treatment regimen(χ^(2)=13.516,P<0.001)were related to pCR,and the differences were statistically significant.In FISH detection,the HER2/chromosome 17 centromere(HER2/CEP 17)ratio(Z=-3.904,P<0.001)and the HER2/cell number ratio were correlated with the pCR rate(Z=-3.493,P<0.001),the difference was statistically significant.In the multivariate regression analyses,the factors that adjusted the estrogen receptor(ER),progesterone receptor(PR)and anti-HER2 treatment regimens,the pCR rate of patients treated with the dual target regimen against HER2 was higher(OR=5.059,95%CI:2.052-12.468,P<0.001),the pCR rate of ER-negative patients was higher than that of ER-positive patients(OR=0.309,95%CI:0.131-0.724,P=0.007).Conclusions Both IHC and FISH are important HER2 detection methods in breast cancer.The detection of HER2/CEP17 ratio by FISH in IHC(2+)population is of great significance for predicting efficacy.Hormone receptor status and anti-HER2 therapy regimens are also important factors affecting the efficacy.
作者
琚倩
史加宁
杨继鑫
李晶晶
张丽英
李烦繁
JU Qian;SHI Jia-ning;YANG Ji-xin;LI Jing-jing;ZHANG Li-ying;LI Fan-fan(Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Xijing Hospital Affiliated to Air Force Military Medical University,Xi'an 710032,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第2期135-140,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
安徽高校自然科学基金(2019A0258)
关键词
乳腺癌
HER2阳性
IHC
FISH
新辅助治疗
曲妥珠单抗
帕妥珠单抗
breast cancer
HER2
fluorescence in-situ hybridization
immunohistochemistry
neoadjuvant therapy
trastuzumab
pertuzumab
作者简介
第一作者:琚倩,女,安徽安庆人,主要从事乳腺癌复发和转移机制研究工作。E-mail:ju_qian@126.com;通讯作者:李烦繁,女,安徽合肥人,博士,副主任医师,副教授,硕士生导师,主要从事乳腺癌复发和转移机制研究工作。E-mail:fflahykdx@163.com
