切换至 "中华医学电子期刊资源库"

中华乳腺病杂志(电子版) ›› 2025, Vol. 19 ›› Issue (01) : 45 -48. doi: 10.3877/cma.j.issn.1674-0807.2025.01.008

综述

HER-2 表达与HER-2 阳性乳腺癌临床病理特征及靶向治疗疗效的关系
辛岗1,2, 刘佳妮2, 胡崇珠2,(), 杨颖2   
  1. 1.067000 河北,承德医学院研究生学院
    2.071000 河北,保定市第一中心医院乳腺外一科
  • 收稿日期:2024-05-09 出版日期:2025-02-01
  • 通信作者: 胡崇珠
  • 基金资助:
    保定市科技局计划项目(2341ZF086)

Relationship between HER-2 expression and clinicopathological characteristics and efficacy of targeted therapy in HER-2 positive breast cancer

Gang Xin, Jiani Liu, Chongzhu Hu(), Ying Yang   

  • Received:2024-05-09 Published:2025-02-01
  • Corresponding author: Chongzhu Hu
引用本文:

辛岗, 刘佳妮, 胡崇珠, 杨颖. HER-2 表达与HER-2 阳性乳腺癌临床病理特征及靶向治疗疗效的关系[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 45-48.

Gang Xin, Jiani Liu, Chongzhu Hu, Ying Yang. Relationship between HER-2 expression and clinicopathological characteristics and efficacy of targeted therapy in HER-2 positive breast cancer[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2025, 19(01): 45-48.

临床实践中,HER-2 阳性乳腺癌通常可根据HER-2 蛋白表达水平的差异分为HER-2 免疫组织化学(IHC)3+和HER-2 2+/FISH+两类。 这两类患者的具体比例尚不明确。 研究表明,两类肿瘤在生物学特性上存在异质性,HER-2 IHC 3+肿瘤较HER-2 IHC 2+/FISH+肿瘤的组织学分级高、激素受体阳性率低、预后差,但对以曲妥珠单克隆抗体为基础的靶向治疗反应更为敏感。 两类患者在年龄、肿瘤大小、淋巴结状况、组织学类型、雄激素受体状态、Ki-67 指数等方面是否存在显著差异,目前尚无明确结论。 现有研究普遍存在样本量小、研究时间跨度大、HER-2 状态判读标准不统一及靶向治疗以曲妥珠单克隆抗体为主等局限性。 因此,有必要深入研究明确HER-2 IHC 3+和HER-2 IHC 2+/FISH+肿瘤是否属于两种独立的分子亚型,并探讨是否应根据HER-2 蛋白表达水平制定差异化的靶向治疗策略,进一步提升乳腺癌的精准治疗水平。

表1 HER-2 状态判读标准更新要点
[1]
Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2024,74(3):229-263.
[2]
郑荣寿,陈茹,韩冰峰,等.2022 年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志, 2024,46(3):221-231.
[3]
Ahn S,Woo JW,Lee K,et al.HER-2 status in breast cancer:changes in guidelines and complicating factors for interpretation[J]. J Pathol Transl Med,2020,54(1):34-44.
[4]
Atallah NM,Alsaleem M,Toss MS,et al.Differential response of HER-2-positive breast cancer to anti-HER-2 therapy based on HER-2 protein expression level[J].Br J Cancer,2023,129(10):1692-1705.
[5]
Giuliani S,Ciniselli CM,Leonardi E,et al.In a cohort of breast cancer screened patients the proportion of HER-2 positive cases is lower than that earlier reported and pathological characteristics differ between HER-2 IHC 3+ and HER-2 IHC 2+/HER-2 amplified cases[J].Virchows Arch,2016,469(1):45-50.
[6]
Loibl S,Gianni L.HER-2-positive breast cancer[J].Lancet,2017,389(10087):2415-2429.
[7]
辛玲,周思成,江泽飞,等.中国118 家三级医院早期HER-2 阳性乳腺癌新辅助治疗现状调查报告[J].中国实用外科杂志,2024,44(1):98-102.
[8]
Horimoto Y,Ishizuka Y, Ueki Y, et al.Comparison of tumors with HER-2 overexpression versus HER-2 amplification in HER-2-positive breast cancer patients[J].BMC Cancer,2022,22(1):242.
[9]
Krystel-Whittemore M,Xu J, Brogi E, et al. Pathologic complete response rate according to HER-2 detection methods in HER-2-positive breast cancer treated with neoadjuvant systemic therapy[J]. Breast Cancer Res Treat,2019,177(1):61-66.
[10]
Chen W,Li FX,Lu DL,et al.Differences between the efficacy of HER-2(2+)/FISH-positive and HER-2 (3+) in breast cancer during dualtarget neoadjuvant therapy[J].Breast,2023,71:69-73.
[11]
朱平,吕泓,柏乾明,等.HER-2 阳性乳腺癌新辅助治疗疗效临床病理学分析[J].中华病理学杂志,2023,52(9):907-911.
[12]
岳瑞雪,孔令欣,郝鑫,等.乳腺癌HER-2 蛋白表达水平预测新辅助治疗疗效的真实世界研究[J/CD].中华临床医师杂志(电子版),2023,17(7):765-770.
[13]
Xu B,Shen JG,Zhang LW,et al.HER-2 protein expression level is positively associated with the efficacy of neoadjuvant systemic therapy in HER-2-positive breast cancer[J].Pathol Res Pract,2022,234:153900.
[14]
Wolff AC,Hammond ME, Schwartz JN, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidemal growth factor receptor 2 testing in breast cancer[J].Arch Pathol Lab Med, 2007,31(1):18-43.
[15]
Wolff AC,Hammond ME,Hicks DG,et al.Recommendations for human epidemal growth factor receptor 2 testing in breast cancer:American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update[J].Arch Pathol Lab Med, 2014, 138(2):241-256.
[16]
Wolff AC,Hammond ME,Allison KH,et al.Human epidemal growth factor receptor 2 Testing in breast cancer:American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update[J]. J Clin Oncol,2018,36(20):2105-2122.
[17]
Wolff AC,Somerfield MR,Dowsett M,et al.Human epidemal growth factor receptor 2 testing in breast cancer: ASCO-College of American Pathologists Guideline Update[J]. J Clin Oncol,2023,41(22):3867-3872.
[18]
Ma F,Yan M,Li W,et al.Pyrotinib versus placebo in combination with trastuzumab and docetaxel as first line treatment in patients with HER-2 positive metastatic breast cancer(PHILA):randomised, double blind,multicentre,phase 3 trial[J].BMJ,2023,383:2665.
[19]
Katayama A,Miligy IM, Shiino S, et al. Predictors of pathological complete response to neoadjuvant treatment and changes to postneoadjuvantHER-2 status in HER-2-positive invasive breast cancer[J].Mod Pathol,2021,34(7):1271-1281.
[20]
Orrù S,Pascariello E, Pes B, et al. Biomarker dynamics affecting neoadjuvant therapy response and outcome of HER-2-positive breast cancer subtype[J]. Sci Rep,2023,13(1):12869.
[21]
Yang ZJ,Xin F, Chen ZJ, et al. Real-world data on neoadjuvant chemotherapy with dual-anti HER-2 therapy in HER-2 positive breast cancer[J]. BMC Cancer,2024,24(1):134.
[22]
Yan H,Xiao H,Zhu J,et al.Association between the HER-2 protein expression level and the efficacy of neoadjuvant chemotherapy in HER-2-positive breast cancer[J].Cancer Manag Res,2020,12:12715-12722.
[23]
Wang Y,Singh K,Dizon D,et al.Immunohistochemical HER-2 score correlates with response to neoadjuvant chemotherapy in HER-2-positive primary breast cancer[J].Breast Cancer Res Treat,2021,186(3):667-676.
[24]
Chen HL, Chen Q, Deng YC. Pathologic complete response to neoadjuvant anti-HER-2 therapy is associated with HER-2 immunohistochemistry score in HER-2-positive early breast cancer[J].Medicine,2021,100(44):e27632.
[25]
Zhu J,Jiao D,Wang C,et al. Neoadjuvant efficacy of three targeted therapy strategies for HER-2-positive breast cancer based on the same chemotherapy regimen[J].Cancers,2022,14(18):4508.
[26]
Shi Q,Qi X,Tang P,et al. A multicenter single-arm trial of neoadjuvant pyrotinib and trastuzumab plus chemotherapy for HER-2-positive breast cancer[J].Med Comm,2023,4(6):e435.
[27]
Nielsen TO, Leung SCY,Rimm DL,et al. Assessment of Ki67 in breast cancer: updated recommendations from the international Ki67 in breast cancer working group[J]. J Natl Cancer Inst,2021,113(7):808-819.
[28]
Perez EA, Reinholz MM, Hillman DW,et al.HER-2 and chromosome 17 effect on patient outcome in the N9831 adjuvant trastuzumab trial[J].J Clin Oncol,2010,28(28):4307-4315.
[29]
Swain SM,Miles D, Kim SB, et al. Pertuzumab, trastuzumab, and docetaxel for HER-2-positive metastatic breast cancer(CLEOPATRA):end-of-study results from a double-blind, randomised, placebocontrolled,phase 3 study[J].Lancet Oncol,2020,21(4):519-530.
[30]
Pegram M,Jackisch C,Johnston SRD,et al.Estrogen/HER2 receptor crosstalk in breast cancer:combination therapies to improve outcomes for patients with hormone receptor-positive/HER2-positive breast cancer[J].Breast Cancer,2023,9(1):45-64.
[31]
Modi S,Jacot W, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER-2-low advanced breast cancer[J].N Engl J Med,2022,387(1):9-20.
[32]
Qi X,Shi Q,Xuhong J,et al.Pyrotinib-based therapeutic approaches for HER-2-positive breast cancer:the time is now[J].Breast Cancer Res,2023,25(1):113.
[1] 王昭雨, 姜军. 乳腺癌外科治疗理论和技术的发展与挑战[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 1-5.
[2] 张群, 李俊杰. 乳腺癌外科十大热点[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 6-11.
[3] 徐航程, 王佳玉. PI3K/AKT/mTOR 信号通路及其靶向治疗在乳腺癌中的应用[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 12-19.
[4] 方婉婷, 商家炜, 孟英爽, 闫婷, 明健. 一步核酸扩增在乳腺癌前哨淋巴结转移检测中的应用[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 20-26.
[5] 王峰, 曲更宝, 王文彦, 代艳亭. 罗汉果醇对人乳腺癌细胞自噬和凋亡的影响[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(01): 27-32.
[6] 吴楚营, 叶凯. 不同部位胃肠道间质瘤的腹腔镜手术策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 224-227.
[7] 苏明, 唐丹萍, 王萍, 何谦. 乳腺癌改良根治术后即刻乳房重建的方法选择研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 231-234.
[8] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[9] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[10] 朱洪浩, 范新祥. 广东省医学会泌尿外科疑难病例多学科会诊(第18期)——女性尿道癌[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 120-124.
[11] 黄忠晶, 张丽东, 伍子奕, 艾军华. 不可切除肝细胞癌的转化治疗[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 41-45.
[12] 孙志鹏, 束斌, 王良, 黄鑫, 王鹏飞, 李广欣, 王小娟, 黎功, 杨世忠. 放疗联合靶向免疫新辅助治疗肝内胆管细胞癌的安全性与疗效[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 92-96.
[13] 李伟男, 杨刚, 熊永福, 李强, 李敬东. 中晚期肝癌TACE 联合靶向免疫转化治疗后成功实施ALPPS 的初步经验[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 97-101.
[14] 王海晶, 米思蓉, 高晶. 胃癌患者血清IGFBP1表达水平与临床病理特征的相关性及其诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(01): 11-15.
[15] 段红良, 赵红梅, 李涛, 辛建锋. 结直肠癌组织SPOCD1表达与临床病理特征及术后复发转移的关系[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(01): 40-45.
阅读次数
全文


摘要