PCR检测Ⅰ期HER-2阳性乳腺癌患者腋窝淋巴结HER-2表达的意义

doi:10.3969/j.issn.1671-7171.2022.01.012

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摘要【目的】探讨聚合酶链反应(PCR)检测对Ⅰ期人表皮生长因子受2(HER-2)阳性乳腺癌腋窝淋巴结HER-2表达检出率的影响及其表达与腋窝淋巴结微转移与预后的关系。【方法】收集两院住院资料完整的128例女性Ⅰ期HER-2阳性乳腺癌患者的临床病理资料,采用PCR检测患者腋窝淋巴结HER-2表达并进行随访,用Kaplan-Meier法进行生存结果分析。【结果】本组128患者病理诊断均为非特殊型浸润性乳腺癌、HER-2阳性、雌激素受体(ER)和孕激素受体(PR)阴性。随访期间,局部复发3例,远处转移13例,其中10例发生转移的患者在随访过程中死亡,无病生存(DFS)为89.1%(114/128)。128例中腋窝淋巴结HER-2 PCR检测86例阴性,42例阳性。HER-2 PCR阳性组和阴性组患者基线临床特征比较差异均无统计学意义(P>0.05)。阳性组DFS为78.6%(33/42),阴性组DFS为94.2%(81/86),二组相比较差异有统计学意义(P<0.05)。阳性组采用曲妥珠单抗治疗27例,DFS为92.6%(25/27),未用15例,DFS为53.3%(8/15),二组DFS比较差异有统计学意义(P<0.05)。阴性组用曲妥株单抗58例,DFS为96.6%(56/58),未用28例,DFS 89.3%(25/28),两组DFS比较差异无统计学意义(P>0.05)。【结论】腋窝淋巴结HER-2 PCR阳性提示患者有微转移,有微转移的患者预后比无微转移的预后差,曲妥珠单抗可改善有腋窝淋巴结微转移患者预后。

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	范舟
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关键词 ：乳腺肿瘤, 受体,erbB-2/分析, 聚合酶链反应, 淋巴结

Abstract：【Objective】Polymerase chain reaction (PCR) can improve the detection rate of micrometastasis. To detect HER-2 expression by PCR in axillary lymph nodes of stage Ⅰ HER-2-postive breast cancer and study its clinical significance. 【Methods】The clinical and pathological data of 128 cases of stage Ⅰ breast cancer with HER-2-postive expression were collected. HER-2 gene expression levels in axillary lymph nodes were detected by PCR. The clinicopathological characteristics, treatment and prognosis were retrospectively analyzed by using the statistical methods such as Kaplan-Meier. 【Results】The pathological type of 128 cases was infiltrative non-specific carcinoma with HER-2 positive expression and negative expression of ER and PR. During follow-up, 3 patients had local recurrence, 13 had distant metastases, and 10 patients had distant metastases who died during follow-up. DFS (disease-free survival) rate was 89.1% (114/128). PCR detection of HER-2 showed that 42 cases were positive expression and 86 cases were negative expression in axillary lymph nodes. The clinicopathological characteristics were not statistically different between the two groups (P>0.05). DFS rate was 78.6% (33/42) in HER-2 positive expression group and 94.2% (81/86) in HER-2 negative expression group, respectively; The difference of DFS rate was statistically significant (P<0.05). In HER-2 positive expression group, 27 patients received trastuzumab treatment and the DFS rate was 92.6% (25/27), while the DFS of 15 patients without receiving trastuzumab was 53.3% (8/15). The difference in DFS between the two groups was statistically significant (P<0.05). In HER-2 negative expression groups, DFS rate was 96.6% (56/58) in 58 cases who received trastuzumab and 89.3% (25/28) in 28 cases without receiving trastuzumab. The DFS rate of two groups had no significant difference (P>0.05). 【Conclusion】Overexpression of HER-2 implies the indication of axillary lymph node micrometastasis. Breast cancer patients with HER-2 positive expression in axillary lymph node have poor prognosis. Trastuzumab can improve the prognosis of patients with micrometastasis of axillary lymph nodes.

Key words： Breast Neoplasms Receptor, ErbB-2 Polymerase Chain Reaction Lymph Nodes

收稿日期: 2021-09-01

中图分类号:

R737.9

通讯作者: *E-mail:441566735@qq.com

引用本文:

范舟, 范培芝. PCR检测Ⅰ期HER-2阳性乳腺癌患者腋窝淋巴结HER-2表达的意义[J]. 医学临床研究, 2022, 39(1): 44-47.
FAN Zhou, FAN Pei-zhi. Clinical Significance of HER-2 Expression Detection by PCR in Axillary Lymph Nodes of StageⅠBreast Cancer with HER-2-postive. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 44-47.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.01.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I1/44

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