HER-2/neu过度表达在淋巴结阴性乳腺癌中的预后价值

目的研究HER-2/neu过度表达在淋巴结阴性乳腺癌中的预后意义.方法对1990～1998年收住的137例腋淋巴结阴性乳腺癌患者肿瘤标本,用免疫组织化学方法检测肿瘤细胞HER-2/neu的表达.分析HER-2/neu的表达与其他临床病理预后指标的相关性.单因素和多因素的方法检测HER-2/neu的过度表达作为预后指标对无复发生存率(RFS)和总生存率(OS)的重要性.结果结果显示HER-2/neu过度表达和其他临床病理指标无关.HER-2/neu过度表达患者的无复发生存率及总生存率显著低于HER-2/neu低表达患者 (P=0.0121和0.0301).对激素受体阳性患者,HER-2/neu过度表达患者的无复发生存率显著低于HER-2/neu低表达患者 (P=0.0011),但对激素受体阴性患者HER-2/neu状态与RFS无关;多因素分析显示 HER-2/neu、肿瘤大小、 p53是影响RFS的独立预后因子.结论在腋淋巴结阴性的乳腺癌患者中,HER-2/neu过度表达与雌激素受体相结合可以更好的判定患者的预后.

The prognosis of HER-2/neu expression in axillary lymph node-negative breast cancer patients

Aim To evaluate the prognostic value of HER-2/neu over-expression in node-negative patients.Methods Specimens from the primary tumors of137axillary lymph node negative patients who underwent surgery between 1990~1998 were studied.Immunohistochemical analysis of HER-2/neu protein expression in breast carcinoma samples was performed.We analyze the association of HER-2/neu over-expression with other clinic-pathological factors by chi-square test.Univariate and multivariate analysis were performed to evaluate the prognostic significanceof HER-2/neu over-expression in relapse free survival(RFS) and overall survival(OS).Results We found HER-2/neu over-expression had no correlation with other clinic-pathological factors(such as menopausal status,tumorsize,tumor grade,p53,ER and histotype).The over-expression of HER2/neu is significantly correlation with RFSand OS in node-negative patients(p=0.0121,0.0301).We also found over-expression of HER-2/neu is a significantly unfavorable prognostic factor for RFS in steroid receptor positive patients(p=0.0011),but not ER negative patients.Multivariate analysis showed that HER-2/neu together with tumor size and p53 was independently prognostic actor for RFS in node-negative patients(P<0.05).Conclusion We concluded that for lymph node-negative patients,HER-2/neu over-expression combined with steroid receptor status can be meaningful to patients` prognosis.