Can breast cancer patients with HER2 dual-equivocal tumours be managed as HER2-negative disease?
Can breast cancer patients with HER2 dual-equivocal tumours be managed as HER2-negative disease?
复制标题
患有 HER2 双重模糊肿瘤的乳腺癌患者能否作为 HER2 阴性疾病进行治疗？
DOI：
10.1016/j.ejca.2017.10.033
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发表时间：
2018-01-01
影响因子：
8.4
通讯作者：
Shen, Kunwei
中科院分区：
文献类型：
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作者：
Tong, Yiwei;Chen, Xiaosong;Shen, Kunwei
背景资料：在2013年美国临床肿瘤学会/美国病理学家学会（ASCO/CAP）指南更新后，报告了人表皮生长因子受体2（HER 2）免疫组织化学（IHC）/荧光原位杂交（FISH）双重可疑乳腺肿瘤增加。本研究的目的是探讨这些患者的临床病理特征，治疗模式和疾病的结果与HER 2双重可疑tumors.Patients和方法：患者与HER 2 IHC 2+和可用的FISH结果进行了回顾性分析，从综合乳腺健康中心，上海瑞金医院。2013年ASCO/CAP指南用于定义HER 2阳性、双重可疑和阴性组。比较了这些组的患者特征、系统治疗模式和生存率。结果：691例患者中，HER 2阳性133例（19.25%），双重可疑25例（3.62%），阴性533例（77.13%）。单变量和多变量分析表明，HER 2双重可疑肿瘤与HER 2阴性肿瘤具有更多的相似性，而HER 2阳性肿瘤具有相当不同的临床病理特征。与HER 2阴性肿瘤相比，HER 2双重可疑肿瘤具有相似的HER 2 mRNA水平（P = 0.26），其与HER 2阳性乳腺癌相比低得多。此外，辅助全身治疗模式在HER 2阴性和双重可疑肿瘤之间相当，并且没有HER 2双重可疑患者接受抗HER 2治疗。结论：HER 2双重可疑肿瘤与HER 2阴性肿瘤在临床病理特征、HER 2 mRNA表达水平、辅助治疗方式及预后等方面具有相似性，值得临床进一步研究。(C)2017爱思唯尔有限公司版权所有
Background: Increasing human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC)/fluorescence in situ hybridisation (FISH) dual-equivocal breast tumours are reported after the 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline update. The aim of this study is to investigate the clinico-pathologic characteristics, treatment patterns and disease outcome of these patients with HER2 dual-equivocal tumours.Patients and methods: Patients with HER2 IHC 2+ and available FISH results were retrospectively analysed from the Comprehensive Breast Health Center, Shanghai Ruijin Hospital. The 2013 ASCO/CAP guideline was applied to define HER2-positive, dual-equivocal and -negative groups. Patient characteristics, systemic treatment patterns and survival were compared among these groups. Reverse transcriptase-polymerase chain reaction-based assays were applied to test HER2 mRNA expression level.Results: Among 691 patients included, 133 (19.25%) were HER2 positive, 25 (3.62%) were HER2 dual-equivocal and 533 (77.13%) were HER2 negative. Univariate and multivariate analyses stated that HER2 dual-equivocal tumours shared more similarity with HER2-negative tumours, whereas HER2-positive tumours had rather different clinico-pathologic features. HER2 dual-equivocal tumours had similar HER2 mRNA levels compared with HER2-negative tumours (P = 0.26), which were much less compared with HER2-positive breast cancer. Besides, adjuvant systemic treatment patterns were comparable between HER2-negative and dual-equivocal tumours, and none of HER2 dual-equivocal patients received anti-HER2 treatment. There was no survival difference among these three groups (P = 0.43).Conclusion: HER2 dual-equivocal tumours share more similarity with HER2-negative disease in terms of clinico-pathologic features, HER2 mRNA levels, adjuvant systemic treatment patterns and disease outcome, which deserves further clinical evaluation. (C) 2017 Elsevier Ltd. All rights reserved.