已发表论文

定量 HER2  基因扩增在乳腺癌患者新辅助治疗预测中的价值及临床意义

 

Authors Wu Z, Xu S, Zhou L, Yin W, Lin Y, Du Y, Wang Y, Jiang Y, Yin K, Zhang J, Lu J

Received 20 November 2017

Accepted for publication 10 January 2018

Published 15 February 2018 Volume 2018:11 Pages 801—808

DOI https://doi.org/10.2147/OTT.S157634

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr XuYu Yang

Background: The aims of this study were to determine whether the quantitative HER2  gene amplification level is related to the key clinicopathological features that represent the aggressiveness of breast cancer (BC) and to determine whether the quantitative HER2  gene amplification level could predict the treatment response in the subset of HER2-positive patients who received neoadjuvant targeted therapy.
Materials and methods: Patients treated with weekly cisplatin- and paclitaxel-based neoadjuvant chemotherapy, who had undergone both immunohistochemistry and the fluorescence in situ hybridization test for HER2 , were included in the study (n=103). For HER2-positive patients, defined as immunohistochemistry score 3+ or fluorescence in situ hybridization ratio ≥2.0, trastuzumab was recommended with neoadjuvant chemotherapy (n=45). Pathological complete response was defined as complete pathological remission of tumor cells both in breast and axillary lymph nodes postoperation.
Results: In all patients enrolled in the study, a higher HER2  amplification level was significantly correlated with larger tumor size and the absence of ER and PR expression. In HER2-positive patients treated with neoadjuvant trastuzumab concurrent with chemotherapy, both univariate and multivariate logistic regression showed that a higher HER2/CEP17  ratio and HER2  gene copy number were associated with a higher pathological complete response rate. When calculated by receiver operating characteristics analysis, an optimal cutoff of 4.5 for the HER2/CEP17  ratio was expected to distinguish the most sensitive candidate for treatment with a combination of trastuzumab and neoadjuvant chemotherapy.
Conclusion: A higher HER2  amplification level was correlated with larger tumor size and reduced ER and PR expression, which may indicate more aggressive tumor behavior. For HER2-positive patients, the HER2/CEP17  ratio and HER2  gene copy number may be good predictive factors for concurrent neoadjuvant trastuzumab and chemotherapy.
Keywords: breast cancer, neoadjuvant, quantitative HER2  gene amplification, pathological complete response, predictive