HER-2表达状态在HER-2阴性乳腺癌新辅助化疗中的疗效相关研究

Study on the Efficacy of HER-2 Expression in Neoadjuvant Chemotherapy for HER2-Negative Breast Cancer

摘要: 目的：调查HER-2阴性乳腺癌患者中，不同的HER-2表达水平对新辅助化疗疗效的影响以及与患者临床病理特征的关系。方法：采集青岛大学附属医院乳腺病诊疗中心于2017年1月~2024年1月在我院确诊乳腺癌并接受新辅助化疗的HER-2阴性乳腺癌患者共164例。将HER-2阴性乳腺癌分为HER-2(0)和HER-2 low两组，分析其临床病理学特征及其与新辅助化疗疗效存在的联系。结果：164例HER-2阴性乳腺癌患者中，总pCR (病理完全缓解)率达到17.1%。HER-2 low乳腺癌患者的pCR率为11.5%，低于HER-2(0)乳腺癌患者的33.3%，其差异有统计学意义(P = 0.001)。同时还发现组织学分级、雌激素受体(ER)和孕激素受体(PR)的状态以及ki-67水平均可能与新辅助化疗疗效相关(P < 0.05)。Logistic回归分析结果表明，组织学分级(OR为3.807，95%CI为1.347~10.758，P = 0.012)和HER-2表达状态(OR为0.380，95%CI为0.146~0.998，P = 0.047)可独立预测pCR，此结论可用于HER-2阴性乳腺癌新辅助化疗。结论：HER-2表达状态的不同可以显著影响HER-2阴性乳腺癌新辅助化疗疗效，且HER-2表达状态与组织学分级是pCR的独立预测因子，可共同指导新辅助化疗。

Abstract: Objective: To investigate the effect of different HER-2 expression levels on the efficacy of neoadjuvant chemotherapy and the relationship with clinicopathological features of patients with HER-2 negative breast cancer. Methods: A total of 164 patients with HER-2 negative breast cancer who were diagnosed with breast cancer and received neoadjuvant chemotherapy in the Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qingdao University from January 2017 to January 2024 were collected. Her-2 negative breast cancer was divided into two groups, HER-2(0) and HER-2 low, and the clinicopathological features of HER-2 negative breast cancer and its relationship with the efficacy of neoadjuvant chemotherapy were analyzed. Results: In 164 patients with HER-2 negative breast cancer, the total pCR rate reached 17.1%. The pCR rate in patients with HER-2 low breast cancer was 11.5%, lower than 33.3% in patients with HER-2(0) breast cancer, and the difference was statistically significant (P = 0.001). It was also found that the status of estrogen receptor (ER) and progesterone receptor (PR) and ki-67 level may be related to the efficacy of neoadjuvant chemotherapy (P < 0.05). Logistic regression analysis showed that histological grade (OR 3.807, 95%CI 1.347~10.758, P = 0.012) and HER-2 expression status (OR 0.380, 95%CI 0.146~0.998, P = 0.047) could independently predict pCR. This conclusion can be used for neoadjuvant chemotherapy for HER-2 negative breast cancer. Conclusion: The difference of HER-2 expression status can significantly affect the efficacy of neoadjuvant chemotherapy for HER-2 negative breast cancer, and HER-2 expression status and histological grade are independent predictors of pCR, which can jointly guide neoadjuvant chemotherapy.