乳腺癌原发灶和转移灶激素受体与HER2表达差异及其影响因素

发布时间：2018-10-13 11:09

【摘要】：目的乳腺癌的治疗已经进入分子分型时代,雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人类表皮生长因子受体-2(human epidermal growth factor receptor 2,HER2)的表达对指导制订乳腺癌治疗方案及评价患者预后等尤为重要。许多研究证实,部分乳腺癌患者原发灶及转移灶激素受体与HER2表达存在差异,影响术后辅助及解救治疗方案的制订,进而影响患者的治疗效果及预后。本研究探讨乳腺癌原发灶与腋窝及远处转移灶之间激素受体与HER2表达的差异及其临床意义,同时分析了造成差异的影响因素。方法以乳腺癌、激素受体(ER和PR)、HER2、原发灶和转移灶为关键词,检索PubMed、CNKI数据库和万方数据库1995-01-2016-10的相关文献。共505篇文章被检索到。纳入标准:原发灶与腋窝转移灶激素受体及HER2表达差异情况,原发灶与远处转移灶激素受体及HER2表达差异情况,原发灶与转移灶激素受体及HER2表达差异情况的临床意义。根据纳入标准最终纳入分析38篇文献。结果在部分乳腺癌患者中,原发灶与腋窝转移灶及远处转移灶激素受体及HER2表达情况存在差异,多数文献报道,乳腺癌原发灶与转移灶ER表达状况变化(阳性转阴性或阴性转阳性)比例约为20%,PR约为20%,HER2约为15%。"肿瘤异质性、抗肿瘤治疗和检测方法"等是影响其表达差异的影响因素。结论推荐对于存在局部及远处转移的乳腺癌患者,同时检测并综合原发灶及转移灶的激素受体及HER2表达情况制订治疗方案。
[Abstract]:Objective the treatment of breast cancer has entered the era of molecular typing. The expression of estrogen receptor (estrogen receptor,ER), progesterone receptor (progesterone receptor,PR) and human epidermal growth factor receptor-2 (human epidermal growth factor receptor 2 (HER2) is very important in guiding the treatment of breast cancer and evaluating the prognosis of breast cancer patients. Many studies have confirmed that there are differences between the expression of hormone receptor and HER2 in primary and metastatic lesions of some breast cancer patients, which affects the formulation of postoperative adjuvant and rescue treatment, and then affects the therapeutic effect and prognosis of the patients. The purpose of this study was to investigate the difference of hormone receptor and HER2 expression between primary breast cancer and axillary and distant metastases and its clinical significance. Methods Breast cancer, hormone receptor (ER and PR), HER2,) primary lesions and metastatic foci were used as keywords to search PubMed,CNKI database and Wanfang database from January 1995 to October 2016-10. A total of 505 articles were retrieved. Inclusion criteria: the difference of hormone receptor and HER2 expression between primary tumor and axillary metastases, the difference of hormone receptor and HER2 expression between primary tumor and distant metastatic focus, and the clinical significance of the difference of hormone receptor and HER2 expression between primary tumor and metastatic focus. According to the inclusion criteria, 38 articles were analyzed. Results in some breast cancer patients, there were differences in the expression of hormone receptor and HER2 between primary breast cancer and axillary metastases and distant metastases. The ratio of ER expression (positive to negative or negative to positive) in primary and metastatic tumors of breast cancer is about 20 and PR is about 20 and HER2 is about 15. " Tumor heterogeneity, antitumor therapy and detection methods are the factors that influence the difference of expression. Conclusion it is recommended that for breast cancer patients with local or distant metastasis, the expression of hormone receptor and HER2 in primary tumor and metastatic tumor should be detected and synthesized.
【作者单位】：济南大学·山东省医学科学院医学与生命科学学院;山东大学附属山东省肿瘤医院外科二病区;
【分类号】：R737.9

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