ObjectiveTo systematically evaluate the correlation of amplification of human epidermal growth factor receptor 2 (HER2) with the clinicopathological characteristics and prognosis of colorectal cancer patients.MethodsPubMed, EMbase, Cochrane Library, Chinese Biomedical Literature Database (CBM), Wanfang, and other databases were searched, and cohort studies focused on the relationship between HER2 amplification and clinicopathological characteristics and prognosis of colorectal cancer patients were included. The retrieval time limit was from October 2020, and RevMan 5.4 software was used for meta-analysis.ResultsA total of 9 studies (11 cohorts) were included for meta-analysis of 7 209 patients with colorectal cancer. Results of the meta-analysis showed that HER2 amplification was not associated with overall survival [HR=1.10, 95%CI (0.98, 1.24), P=0.11]. HER2 amplification was not correlated with gender [OR=0.98, 95%C1 (0.74, 1.31), P=0.90] and tumor differentiation [OR=0.80, 95%C1 (0.49, 1.32), P=0.39], but correlated with the tumor location [OR=1.85, 95%C1 (1.01, 3.37), P=0.04], RAS wild-type gene [OR=6.36, 95%C1 (3.41, 11.87), P<0.000 01], TNM stage [OR=0.45, 95%C1 (0.32, 0.64), P<0.000 01], lymph node metastasis [OR=1.54, 95%C1 (1.12, 2.13), P=0.008], and the depth of tumor invasion [OR=0.17, 95%C1 (0.05, 0.55), P=0.003].ConclusionCurrent evidence shows that HER2 amplification is not associated with OS in patients with colorectal cancer, but associated with tumor infiltration, lymph node metastasis, TNM stage, tumor site, and RAS genotype.
ObjectiveTo explore the correlation between the texture features of gastric cancer plain CT images and the expression of HER2.MethodsA retrospective collection the datas of 62 patients with gastric cancer who underwent CT scans of the upper abdomen and (or) the whole abdomen from January 2017 to January 2021 in Leshan City People’s Hospital. The treatment method was surgery. The HER2 expression of gastric cancer tissue was detected after the operation. There were 45 male patients and 17 female patients. Lauren classification: 18 cases of intestinal type, 30 cases of diffuse type, and 14 cases of mixed type. Fifty-two cases were HER2 expression negative [age: (63.54±10.32) years], and 10 cases were HER2 expression positive [age: (61.70±11.70) years]. The MaZda module in the MaZda 4.6 version software was used to perform the image normalization, interest area delineation, texture feature extraction, and texture feature selection on the CT plain scan image, and perform texture feature discrimination and misjudgment rate analysis in the B11 module.ResultsThere was no correlation between HER2 expression and age, gender of patients and Lauren classification of tumors (P>0.05). The analysis methods of nonlinear discriminant analysis (NDA)/artificial neural network (ANN), linear discriminant analysis (LDA)/1-nearest-neighbor (1-NN), principal component analysis (PCA)/1-NN, and raw-data analysis (RDA)/1-NN can better correspond to the CT plain scan texture feature parameters of gastric cancer and the expression level of HER2.ConclusionsTexture analysis based on CT plain images has the potential to non-invasively detect the HER2 expression in gastric cancer. The best comprehensive performance texture discrimination method is NDA/ANN and LDA/1-NN.
ObjectiveTo summarize the correlation between human epidermal growth factor receptor 2 (HER2) gene expression and the efficacy of targeted therapy for patients with HER2-positive breast cancer, and to summarize the new progress in the study of HER2 gene copy number. MethodThe relevant literatures on researches of targeted therapy effectiveness for patients with HER2-positive breast cancer were retrieved and reviewed. ResultsHER2 gene copy number and HER2/centromere on chromosome 17 (CEP17) ratio were related to the prognosis of patients with HER2-positive breast cancer, and circulating tumor DNA sequencing was expected to be a predictive indicator of targeted therapy effectiveness. ConclusionHigher copy number of HER2 gene might be associated with a better prognosis of HER2-positive breast cancer, and HER2/CEP17 ratio and circulating tumour DNA are of some significances in evaluating treatment response of trastuzumab for patients with HER2-positive breast cancer.
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.
Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
ObjectiveTo analyze the clinicopathologic characteristics and prognosis of human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients with different expression status of estrogen receptor (ER). MethodsThe patients with HER2-negative breast cancer met the inclusion and exclusion criteria and were treated in the Affiliated Hospital of Southwest Medical University from January 1, 2017 to December 31, 2019 were retrospectively collected, and then were assigned into 3 groups according to the ER expression status: ER-negative (ER expression positive rate <1%) group, ER-low expression (ER expression positive rate 1%–10%) group, and ER expression positive rate >10% group. The differences of clinicopathologic characteristics, therapy, and prognosis among the 3 groups were compared. And the risk factors affecting recurrence and metastasis of patients with ER-low expression were analyzed by Cox proportional hazards regression model. ResultsA total of 610 patients with HER2-negative breast cancer were included in this study, including 130 patients in the ER-negative group, 48 patients in the ER-low expression group, and 432 patients in the ER expression positive rate >10% group. The Bonferroni method was used to correct the test level after pairwise comparison, it was found that the histological grade was later (P<0.001, P=0.023) and the Ki-67 expression was higher (P<0.001, P=0.023) in the ER-negative group and ER-low expression group as compared with the ER expression positive rate >10% group; The proportion of the patients receiving chemotherapy in the ER-negative group was higher than that of the ER expression positive rate >10% group (χ2=10.310, P=0.001), while which had no statistical difference between the ER-low expression group and the ER-negative group or the ER expression positive rate >10% group (Fisher exact probability method, P=1.000; χ2= 3.585, P=0.058); The proportion of patients receiving endocrine therapy in the ER-low expression group was higher than that in the ER-negative group (χ2=36.333, P<0.001) and lower than the ER expression positive rate >10% group (χ2=246.996, P<0.001). The difference in disease-free survival (DFS) curves among 3 groups was statistically significant (χ2=46.805, P<0.001); There were no statistical differences in the overall survival (OS) curve and DFS curve between the ER-negative group and the ER-low expression group (Two stage test, P=0.786; χ2=1.141, P=0.286), and which in the ER expression positive rate >10% group were significantly better than thoses in the ER-negative group (χ2=10.137, P=0.001; χ2=39.344, P<0.001) and the ER-low expression group (χ2=4.075, P=0.044; χ2=31.911, P<0.001). The results of multivariate Cox proportional hazards regression analysis showed that N1 and N2 [N0 as reference: RR (95%CI)=7.740 (1.939, 30.897), P=0.004; RR (95%CI)=9.513 (1.990, 45.478), P=0.005) and T3 [T1 as reference: RR (95%CI)=27.357 (2.188, 342.041), P=0.010] increased the probabilities of recurrence and metastasis HER2-negative breast cancer patients with ER-low expression. ConclusionsAccording to results of this study, patients with HER2-negative breast cancer showed certain differences in histological grade and Ki-67 expression among patients with three different ER expression status, but no statistical difference is found between ER-low expression and ER-negative breast cancer, and the prognoses of both are worse than that of ER expression positive rate >10% breast cancer patients. Lymph node metastasis and larger tumor are risk factors affecting recurrence and metastasis in ER-low expression breast cancer patients.
ObjectiveTo investigate the influencing factors of total pathological complete response (tpCR) in newly treated human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients after neoadjuvant targeted chemotherapy, so as to provide more reference for the formulation of surgical plan and prognosis assessment. MethodsNinety-five newly treated HER2-positive breast cancer patients after neoadjuvant targeted chemotherapy were retrospectively chosen in the period from January 2021 to January 2023 in our hospital and all patients were divided into tpCR group (51 cases) and non-tpCR group (44 cases) according to whether tpCR was achieved after neoadjuvant targeted chemotherapy or not. Univariate and multivariate methods were used to evaluate the independent influencing factors of tpCR after neoadjuvant targeted chemotherapy in newly treated HER2-positive breast cancer patients. The prediction model based on the above independent influencing factors was constructed and the potential predictive efficacy of this model for tpCR after neoadjuvant targeted chemotherapy was evaluated. ResultsAmong 95 patients, 51 patients achieved tpCR after neoadjuvant targeted chemotherapy and 44 patients did not achieve tpCR. The results of the multivariate logistic regression model analysis showed that the patients with HER2 3+(OR=6.102, P=0.014), HER2+/hormone receptor– (HER2+/hormone receptor+ OR=0.129, P=0.006), and trastuzumab+pantomizumab treatment (OR=6.582, P=0.014) had higher tpCR rate, estrogen receptor 3+ (OR=0.122, P=0.0.033), progesterone receptor 3+ (OR=0.179, P=0.020), Ki-67 index of 15%–30% (OR=0.088, P=0.030) and 31%–60% (OR=0.066, P=0.017) had lower tpCR rate. The predicted area under the curve of this model was 0.881 [95%CI (0.815, 0.947)]. ConclusionsThe achievement of tpCR after new adjuvant treatment in newly diagnosed HER2 positive breast cancer patients is related to the expression level of HER2 in immunohistochemistry, molecular typing and new adjuvant targeted treatment scheme. At the same time, the prediction model based on these influencing factors can predict the effect of tpCR after new adjuvant treatment in patients to a certain extent.
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.