摘要
目的探讨人类表皮生长因子受体2(HER2)阳性乳腺癌HER2蛋白表达水平预测曲妥珠单抗和帕妥珠单抗(HP)为基础新辅助治疗疗效的价值,为合理选择抗HER2靶向治疗模式提供依据。方法回顾性收集在保定市第一中心医院等河北省共11家三级甲等医院接受曲妥珠单抗及帕妥珠单抗配伍化疗方案新辅助治疗并完成后续手术的HER2阳性乳腺癌患者的临床资料,分析HER2蛋白表达水平与临床病理特征以及总体病理完全缓解(tpCR)率的相关性。结果共纳入180例患者,其中HER2 IHC3+组157例(87.2%),HER2 IHC2+/FISH+组23例(12.8%)。HER2 IHC3+组tpCR率显著高于HER2 IHC2+/FISH+组(65.0%vs 17.4%,P<0.001)。HER2蛋白表达水平与激素受体(hormone receptor,HR)状态相关,HER2 IHC 2+/FISH+组HR阳性率显著高于HER2 IHC 3+组(87%vs 49.7%,P=0.001),与年龄、月经状态、肿瘤大小、淋巴结状况、肿瘤临床分期、Ki-67增殖指数等无相关性。结论乳腺癌HER2蛋白表达水平对曲妥珠单抗和帕妥珠单抗配伍化疗新辅助治疗方案的疗效有一定的预测价值,HER2 IHC2+/FISH+患者疗效欠佳,有必要探索适合此类患者的抗HER2靶向治疗模式。
Objective To assess the value of human epidermal growth factor receptor 2(HER2)protein expression levels in predicting the efficacy of trastuzumab plus pertuzumab(HP)as a basic neoadjuvant therapy for HER2-positive breast cancer patients,so as to provide a basis for the rational selection of HER2-targeted therapy mode.Methods The clinical data of HER2-positive breast cancer patients who received neoadjuvant therapy with trastuzumab plus pertuzumab chemotherapy and underwent subsequent surgery at 11 tertiary hospitals in Hebei Province,including Baoding No.1 Central Hospital,,were retrospectively collected to analyze the association between HER2 expression levels and clinicopathological characteristics and total pathological complete response(tpCR)rate.Results A total of 180 patients were enrolled,including 157(87.2%)in the HER2 IHC3+group and 23(12.8%)in the HER2 IHC2+/FISH+group.The tpCR rate in the HER2 IHC3+group was significantly higher than that in the HER2 IHC2+/FISH+group(65.0%vs 17.4%,P<0.001).The expression levels of HER2 protein were related to hormone receptor(HR)status,and the positive rate of HR in the HER2 IHC2+/FISH+group was significantly higher than that in the HER2 IHC 3+group(87.0%vs 49.7%,P=0.001),and the expression levels of HER2 protein had no correlation with age,menstrual status,tumor size,lymph node status,tumor clinical stage,or Ki-67 proliferation index.Conclusion The expression level of HER2 protein in breast cancer has appreciated predictive value for the efficacy of neoadjuvant therapy with trastuzumab and pertuzumab in combination with chemotherapy,and HER2 IHC2+patients have poor efficacy.It is necessary to explore anti-HER2-targeted therapy mode which is suitable for HER2 IHC2+patients.
作者
岳瑞雪
孔令欣
郝鑫
杨进强
韩猛
崔国忠
王建军
张志生
孔凡庭
张维
何文博
李现桥
周新平
徐东宏
胡崇珠
Yue Ruixue;Kong Lingxin;Hao Xin;Yang Jinqiang;Han Meng;Cui Guozhong;Wang Jianjun;Zhang Zhisheng;Kong Fanting;Zhang Wei;He Wenbo;Li Xianqiao;Zhou Xinping;Xu Donghong;Hu Chongzhu(The First Department of Breast Surgery,Baoding No.1 Central Hospital,Baoding 071000,China;Department of Thoracic Surgery,Hebei General Hospital,Shijiazhuang 050000,China;Department of Breast Surgery,the Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Glandular Vascular Surgery,Harrison International Peace Hospital,Hengshui 053000,China;Breast Disease Center,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;The Second Department of Thyroid Breast Surgery,Cangzhou Central Hospital,Cangzhou 061001,China;Department of Breast Surgery,Hebei Petrochina Central Hospital,Langfang 065000,China;Department of Breast Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Breast Surgery,Xingtai People's Hospital,Xingtai 054001,China;The First Department of Thyroid Breast Surgery,Cangzhou Central Hospital,Cangzhou 061001,China;Department of Glandular Surgery,Dingzhou People's Hospital,Dingzhou 073000,China;The First Department of Breast Surgery,The Affiliated Hospital of Hebei University of Engineering,Handan 056001,China;Department of Breast Surgery,Handan Central Hospital,Handan 056001,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2023年第7期765-770,共6页
Chinese Journal of Clinicians(Electronic Edition)
基金
保定市科技计划项目资助(2141ZF242)
关键词
乳腺癌
新辅助治疗
人类表皮生长因子受体2
免疫组织化学
荧光原位杂交
Breast cancer
Neoadjuvant therapy
Human epidermal growth factor receptor 2
Immunohistochemistry
Fluorescence in situ hybridization
作者简介
通信作者:胡崇珠,Email:hcz69@sina.com
