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目的探讨乳腺癌患者复发前后HER-2和激素受体表达是否存在时间变异性。方法收集168例长期随访(>5年)的乳腺癌患者不同时间点的组织标本,并通过免疫组织化学进行HER-2、ER和PR检测,比较不同时间点上述生物标志的差异,同时分析与患者原始治疗和复发后治疗的关系。结果 168例乳腺癌患者中,36例复发,对其中27例复发组织标本进行检测。发现5例患者出现HER-2表达状态的变化,其中3例HER-2下调,2例上调;7例出现ER变化:5例ER表达下调,2例ER表达上调。2例出现PR下调。HER-2的表达变化与复发前放化疗无明显联系,但抗激素治疗导致HR表达下调,激素受体变化对随后的化疗治疗效果稍差(76%vs.88%,P=0.21),无疾病进展时间相似(33.4月vs.38.60月,Log-rank=1.96,P=0.16)。结论乳腺癌患者HER-2和激素受体的表达可以随时间变异,复发患者需要再次检测上述生物标志。
Objective To investigate whether there is temporal variability in the expression of HER-2 and hormone receptors before and after breast cancer recurrence. Methods Tissue samples from 168 patients with breast cancer at different time points (>5 years) were collected. HER-2, ER, and PR were detected by immunohistochemistry. Differences in the above biomarkers at different time points were analyzed and analyzed. The relationship between the patient’s original treatment and post-relapse treatment. Results Of the 168 breast cancer patients, 36 relapsed and 27 of them were tested for recurrence. The changes in HER-2 expression status were found in 5 patients, of which HER-2 was down-regulated in 3 cases and up-regulated in 2 cases; ER changes occurred in 7 cases: down-regulation of ER in 5 cases and up-regulation of ER in 2 cases. 2 cases of PR reduction. The expression of HER-2 was not significantly associated with pre-retroradiotherapy and chemotherapy, but anti-hormone treatment resulted in down-regulation of HR expression, and hormone receptor changes were less effective for subsequent chemotherapy (76% vs. 88%, P=0.21). The disease progression time was similar (33.4 months vs. 38.60 months, Log-rank=1.96, P=0.16). CONCLUSIONS: The expression of HER-2 and hormone receptors in breast cancer patients may fluctuate over time, and patients with relapse need to be tested again for these biomarkers.