ObjectiveTo compare the clinicopathological characteristics and prognosis of young early breast cancer patients with different human epidermal growth factor receptor 2 (HER2) expression levels, and to analyze the clinicopathological characteristics and prognosis of young early breast cancer patients with low HER2 expression. MethodsA total of 1 723 breast cancer patients who were treated in the Department of Breast Surgery of the First Affiliated Hospital of Xi’an Jiaotong University between June 2016 and June 2018 were collected and divided into three groups: HER2-negative, low-expression, and high-expression. The clinicopathological characteristics of the three groups were compared, and the relationship between HER2 expression and patients’ prognosis was analyzed. ResultsThere were 512 HER2-negative patients, 748 HER2-low expression patients, and 463 HER2-high expression patients. The results of the clinical pathological characteristics analysis of the three groups of patients showed that there were no statistical differences in marital status, menopausal status, family history, single T stage (tumor size), single M stage (distant metastasis), affected side, vascular tumor thrombus, and radiotherapy in the three groups of breast cancer patients with different HER2 expression levels (P>0.05). However, there were statistical differences in age, Ki-67 expression level, N stage, TNM stage, surgical method, estrogen receptor and progesterone receptor status, histological type, histological grade, whether to receive neoadjuvant therapy and adjuvant chemotherapy in breast cancer patients with different HER2 expression levels (P<0.05). The results of survival analysis showed that the prognosis of early breast cancer patients may not be significantly correlated with the HER2 expression level, and the prognosis of young early breast cancer patients may also not be statistically correlated with the HER2 expression status. ConclusionsBreast cancer patients with different HER2 expression levels differ in multiple clinicopathological characteristics, but these differences do not significantly affect the prognosis of the patients. Especially for early-stage breast cancer, HER2 expression levels do not seem to have a significant impact on prognosis. This suggests that HER2 status may not be a decisive factor in treatment and prognosis assessment, and other pathological characteristics and treatment methods need to be considered comprehensively. The prognosis of young breast cancer patients in early stage may also not be statistically correlated with HER2 expression status.
Objective To investigate the clinicopathological characteristics of HER2 protein expression in different degrees in human epidermal growth factor receptor 2 (HER2) negative breast cancer and the factors related to the efficacy of neoadjuvant chemotherapy in breast cancer with low HER2 expression. Methods The clinicopathological data of 161 patients with HER2-negative breast cancer who received neoadjuvant chemotherapy in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from March 2019 to March 2022 were retrospectively collected. The difference of clinical and pathological characteristics of patients with different levels of HER2 protein expression were analyzed, and the factors influencing the pathological complete remission (pCR) rate of breast cancer patients with low HER2 expression after neoadjuvant chemotherapy with unconditional logistic regression model were analyzed. Results Among 161 HER2 negative breast cancer patients, 108 cases were low HER2 expression, accounting for 67.1%. Compared with those with zero expression of HER2 [immunohistochemistry (IHC) 0], the patients with low HER2 expression had higher axillary lymph node metastasis rate (P=0.048), lower histological grade (P=0.006), and higher proportion of positive hormone receptor expression (P<0.001). There was no significant difference in pCR rate among the HER2 IHC 0, IHC 1+ and IHC 2+ / in situ hybridization (ISH)– (P=0.099) , and the pCR rate of low expression of HER2 was lower than that of zero expression of HER2 in the general population and Luminal subgroup, and the difference was statistically significant (P<0.05). There was no significant difference in triple negative breast cancer subgroup (P=0.814). The logistic regression analysis showed that age, histological grade and estrogen receptor expression status were independent influencing factors for pCR rate after neoadjuvant chemotherapy with low HER2 expression (P<0.05). Conclusions Different degrees of HER2 protein expressions in patients with HER2-negative breast cancer have unique clinicopathological characteristics. The pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer is lower than that in patients with zero HER2-expression breast cancer. Age, histological grade and estrogen receptor expression status are independent factors influencing the pCR rate of neoadjuvant chemotherapy in patients with low HER2-expression breast cancer.
目的 研究乳腺癌患者雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）表达情况及免疫组织化学分子亚型分布。 方法 对2003年1月－2008年9月四川大学华西医院病理科3 365例乳腺癌病理报告存档资料进行激素受体（ER/PR）、HER-2表达情况及免疫组织化学分子亚型分布进行分析。 结果 3 365例确诊的乳腺癌患者中，ER阳性1 824例（54.2%），PR阳性1 841例（54.7%），HER-2过表达284例（8.4%）。相关分析显示ER与PR表达呈正相关（P＜0.001），HER-2与ER、PR表达均呈负相关（P＜0.001）。免疫组织化学分子亚型结果显示luminal A型最常见，为1 993例（59.2%）；basal-like型为623例（18.5%）；HER-2过表达型为169例（5.0%）；luminal B型最少，为115例（3.4%）；未分类的为465例（13.8%）。 结论 乳腺癌患者激素受体及HER-2表达有特殊性，激素受体阳性率＞50%，HER-2阳性率在不同研究中显示出不同的结果，尚需进一步研究；ER、PR与HER-2具有良好的相关性；免疫组织化学分子亚型中luminal A型最常见。
目的 探讨不同分子分型乳腺浸润性导管癌手术病例标本中P53、表皮生长因子受体（EGFR）和Ki-67的表达及临床意义。 方法 采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连接法法对2010年1月－2011年7月446例乳腺浸润性导管癌患者标本进行分子分型，并同时检测其P53、EGFR、Ki-67等的表达。 结果 P53和Ki-67在人类表皮生长因子受体2（HER2）过表达型、基底细胞样型、未分类型中的表达明显强于管腔A型及管腔B型（P＜0.05）；HER2过表达型和未分类型中的EGFR表达明显强于管腔A型及管腔B型（P＜0.05）。 结论 在使用雌激素受体、c-erbB-2等指标对浸润性导管癌进行分子分型时同时检测P53、EGFR及Ki-67等标记物，有助于更加精准的评估肿瘤的生物学行为及预后 ，对靶向药物的个体化治疗提供参考和疗效预测有重要意义。
ObjectiveTo explore the relationship of the clinicopathological characteristics of non-small cell lung cancer (NSCLC) with the mutations of epidermal growth factor receptor (EGFR), K-ras and EML4-ALK fusion gene in cell blocks of pleural effusion (PLE). MethodsA total of 268 cytological specimens of PLE (pleural effusion), from Central Hospital of Zibo city were collected from advanced NSCLC patients between January 2012 year and June 2014 year. There were 165 male and 103 female patients at age of 53.6 (31-76) years. Qualitative diagnosis has been made in the 268 patients using PLE samples with conventional smear. Immunohistochemical staining combined with cell block section were used for further classification. There were 76 patients diagnosed as NSCLC with 39 patients of adenocarcinoma and 37 patients of squamous-cell carcinoma. In the 76 patients of lung biopsy specimens and PLE, EGFR and K-ras mutations, EML4-ALK fusions were tested. ResultsEGFR mutations rate was 34.21% (26/76). K-ras mutations rate was 6.58% (5/76). EML4-ALK fusions rate was 7.89% (6/76) at the same time. EGFR and K-ras mutations, EML4-ALK fusions were mostly found in young female adenocarcinoma patients who were non-smokers. EGFR and K-ras mutations or EML4-ALK fusions were not found in the same patient. ConclusionCytological specimens are feasible for detecting EGFR were K-ras mutations and EML4-ALK fusions. This will especially benefit to patients whose histological specimen can not be obtained.
Abstract： Objective To investigate the expression and correlation of phosphatase and tensin homologue deleted on chromosome ten(PTEN)， epidermal growth factor receptor(EGFR) and Ki-67 in human thymic tumors, and their possible role in tumor genesis， infiltration and metastasis. Methods The expression of PTEN， EGFR and Ki-67 were detected by using SP immunohistochemical technique in 45 cases of thymic tumors and 5 cases of normal thymic tissues. Results In 5 cases of normal thymic tissues, the expression of PTEN was bly positive, whereas EGFR and Ki -67 were weakly positive or negative. In 45 cases of thymic tumors, the positive ratio of PTEN were significantly reduced from benign thymoma， invasive thymoma to thymic carcinoma (χ2=7.808, P=0.020), but the positive ratio of EGFR and Ki-67 were gradually increased(χ2=8.032, 0.018，7.006；P=0.030). The positive ratio of PTEN， EGFR and Ki-67 protein were significantly related to Levine classification, Masaoka staging and lymph node metastasis (Plt;0.05). PTEN positive cases were negatively correlated with EGFR and Ki-67(r=－0.632，－0.653；Plt;0.01), EGFR positive cases were positively correlated with Ki-67 in thymic tumors(r=0.807,Plt;0.01). Conclusions Reduced or absent PTEN and increased EGFR and Ki-67 expression might play an important role in the genesis， invasiveness and metastasis of thymic tumors. The expression of PTEN is bly associated with the expression of abnormal EGFR and Ki-67. Detection of the three protein expressions simultaneously might be more helpful in making an early diagnosis of the tumors jndgement of theirs malignant degree，invasiveness and metastasis capacity, as well as the prognosis.
ObjectiveTo summarize and analyze the long-term follow-up results and the recent researches of anti-epidermal growth factor receptor-2 (HER-2) dual targeted therapy for patients with human HER-2-positive breast cancer in terms of neoadjuvant, adjuvant, and salvage treatment so as to further improve the understanding of dual targeted therapy against HER-2 in clinical practice.MethodThe literatures on studies of dual targeted therapy for patients with HER-2-positive breast cancer in recent years were reviewed and analyzed.ResultThe anti-HER-2 dual targeted therapy could achieve a higher pathological complete response rate and better prognosis in the neoadjuvant therapy, as well as in adjuvant therapy and salvage treatment.ConclusionIn recent years, different combinations of targeted drugs in neoadjuvant, adjuvant, and salvage treatment of patients with HER-2-positive breast cancer have shown a benefit in clinical application, but more large sample prospective clinical researches are needed so as to find out optimal combination of targeted drugs with more benefits, less complications, and more economies.
Objective To explore the effect of membrane surface nucleolin （NCL） on activation of epidermal growth factor receptor （EGFR） signaling. Methods Immunohistochemistry was used to identify the expressions of membrane surface NCL or EGFR in pallilary thyroid carcinoma （PTC） tissues. The level of phosphorlated EGFR in TPC-1 cells was observed by Western blot. TPC-1 cells invasion capacity was detected by Transwell assay. Results The posi-tive expression rates of membrane surface NCL and EGFR in PTC tissues were 100% （56/56） and 80.4% （45/56） respe-ctively， while the expressions of NCL and EGFR were related with lymph node metastasis （P＜0.05）. There was posi-tive correlation between the expressions of NCL and EGFR （r=0.635， P＜0.01）. Western blot showed that anti-NCL or anti-EGFR of TPC-1 cells could inhibit the expression of phosphorlation EGFR （P＜0.01）. Transwell assay showed the number of membrane-invading cells were reduced significantly in anti-NCL group anti-EGFR group （P＜0.01）. Conclusions Membrane surface NCL may be a kind of indispensable component in activation of EGFR signaling， by which EGFR can participate in growth and invasion of tumors. NCL can be used as a target for developing a new field of tumor treatment.
Objective To analyze the factors associated with the adoption of targeted therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer and to generate evidence to inform decision-making on public security policy regarding innovative anticancer medicines for the benefit of patients. Methods The study population comprised female patients diagnosed with HER2-positive breast cancer and treated at Fujian Cancer Hospital from 2014 to 2020. The patients were eligible for targeted therapy. The demographic and sociological characteristics and clinical information of patients were extracted from the hospital information system. We performed binary logistic regression analysis of factors associated with the adoption of targeted therapy in patients with HER2-positive breast cancer. We also divided the participants into two groups according to their tumor stage for subgroup analysis. Results A total of 1 041 female patients with HER2-positive breast cancer were included, among them, 803 received targeted therapy. In September 2017, molecular-targeted medicines for HER2-positive breast cancer began to be included in the local basic health insurance program. Only 282 (35.1%) patients adopted targeted therapy before September 2017, after which this number increased to 521 (64.9%). Among the patients who adopted targeted therapy, most were formally employed (45.8%) and enrollees of the urban employee health insurance program (66.0%). Among those who did not adopt targeted therapy, most were unemployed (42.4%) and enrollees of the resident health insurance program (50.0%). Binary logistic regression analysis revealed that patient occupation, gene expression of estrogen receptor, tumor stage, surgery or not, radiotherapy or not, and undergoing treatment before or after September 2017 were correlated with the adoption of targeted therapy (P<0.05). Conclusions Inclusion of targeted medicines for HER2-positive breast cancer in the health insurance program substantially increased the overall administration of these therapies. Individual affordability is a critical factor associated with the application of targeted therapy in eligible patients. Future policies should enhance the public security of patients with a relatively weak ability to pay and provide insurance coverage for innovative anti-cancer medicines.