Racial differences in the overexpression of epidermal growth factor type II receptor (HER2/neu): A major prognostic indicator in uterine serous papillary cancer
Racial differences in the overexpression of epidermal growth factor type II receptor (HER2/neu): A major prognostic indicator in uterine serous papillary cancer
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DOI：
10.1016/j.ajog.2004.10.605
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发表时间：
2005-03-01
影响因子：
9.8
通讯作者：
Pecorelli, S
中科院分区：
文献类型：
--
作者：
Santin, AD;Bellone, S;Pecorelli, S
目的：黑人和白色人子宫体癌患者的生存率存在差异。本研究旨在确定HER 2/qeu癌基因的过表达是否与子宫浆液性乳头状子宫内膜癌（子宫内膜癌的一种高度侵袭性变体）的不良结局相关，以及HER 2/neu过表达频率的种族差异是否可能导致子宫内膜癌生存率的差异。免疫组化评价用于检查27例IA至IV期子宫浆液性乳头状子宫内膜癌患者石蜡块中的HER 2/neu表达。进行单变量分析，然后进行多变量分析与考克斯的比例风险模型，以评估是否HER 2/neu表达与子宫浆液性乳头状子宫内膜cancer.Results的不良结局：黑人患者往往是年轻的（P = 0.02），并有较高的HER 2/neu表达比白色患者（趋势P -0.02）。10例黑人患者中有7例（70%）显示重度（3+）表达，而17例白色患者中有4例（24%; P = 0.04）。通过分层控制HER 2/neu高表达与种族的相关性（P = 0.05）。子宫浆液性乳头状内膜早期死亡。在HER 2/neu高表达者（P = 0.002）、黑人患者（P = 0.04）和小于或等于65岁的患者（P = 0.04）中观察到癌症。然而，多变量考克斯回归分析显示，短生存期与HER 2/neu高表达显著相关（P = 0.02）但不随年龄增长（P =.07）或种族（P = 0.35），这表明HER 2/neu表达是该患者人群生存期种族差异的主要原因。子宫浆液性乳头状子宫内膜癌中HER 2/neu的过表达是一个独立变量，与不良结局相关，在黑人女性中更常见，并可能导致生存的种族差异。HER 2/neu表达可能指导子宫浆液性乳头状子宫内膜癌患者的临床治疗，并可能对实施新的治疗策略产生影响。(C)2005年爱思唯尔公司All rights reserved.
Objective: A difference in survival rates between black and white patients with cancer of the corpus uteri is well established. This study was conducted to determine whether the overexpression of HER2/qeu oncogene is associated with poor outcome in uterine serous papillary endometrial cancer, which is a highly aggressive variant of endometrial cancer, and whether a racial difference in the frequency of HER2/neu overexpression may contribute to the disparity in endometrial cancer survival.Study design: Immunohistochemical evaluation was used to examine HER2/neu expression in paraffin blocks from 27 women with stage IA to IV uterine serous papillary endometrial cancer. Univariable analysis was performed and followed by multivariable analysis with Cox's proportional hazard model to evaluate whether HER2/neu expression was associated with poor outcome in uterine serous papillary endometrial cancer.Results: Black patients tended to be younger (P =.02) and have higher HER2/neu expression than white patients (trend P -.02). Seven of 10 black patients (70%) showed heavy (3+) expression, compared with 4 of 17 white patients (24%; P =.04). The association of heavy HER2/neu expression with race persisted after age was controlled through stratification (P =.05). Earlier deaths from uterine serous papillary endometrial. cancer were seen among heavy HER2/neu expressers (P =.002), black patients (P =.04), and patients less than or equal to65 years old (P =.04). However, multivariate Cox regression showed that short survival was associated significantly with heavy HER2/neu expression (P =.02) but not with age (P =.07) or race (P =.35), which indicates that HER2/neu expression accounted for much of the race disparity in survival in this patient population.Conclusion: Overexpression of HER2/neu in uterine serous papillary endometrial cancer is an independent variable that is associated with poor outcome, occurs more frequently in black women, and may contribute to racial disparity in survival. HER2/neu expression may guide clinical treatment of patients with uterine serous papillary endometrial cancer and may have implications for the implementation of novel treatment strategies. (C) 2005 Elsevier Inc. All rights reserved.