HER2阴性或低表达是I/II期子宫癌患者的不利预后因素
HER2-negative or low expression as an unfavorable prognostic factor in patients with stage I/II uterine carcinosarcoma
影响因子:3.70000
分区:医学2区 / 妇产科学3区 肿瘤学3区
发表日期:2025 Jan
作者:
Chiharu Mizoguchi, Tadaaki Nishikawa, Hiroshi Yoshida, Masanori Yasuda, Tomoyasu Kato, Kosei Hasegawa, Kan Yonemori
摘要
子宫癌（UCS）是罕见的高级子宫内膜癌，治疗方案有限。我们评估了人类表皮生长因子受体2（HER2）表达和HER2基因扩增的预后意义，并阐明了HER2-LOW UCS的临床病理学特征。我们使用Vivo诊断Her2 Impliention Intociention Intosemention（IMSPLENIC）在148名患者中检查了HER2蛋白的HER2蛋白表达（根据美国最新的美国临床肿瘤学学会/美国病理学家学院的胃癌标准，评估了72例患者的杂交（FISH）。在41例患者中为阴性，在57名患者中观察到1+的低表达，在57名患者中观察到1+的低表达，并且在38名患者中观察到HER2高表达（在12名患者中2+）。基于HER2蛋白表达状态，临床病理特征没有显着统计学差异。与高表达相比，HER2阴性和低表达显示I/ II期的总生存率差。与其他癌症类型相比，IHC和鱼类结果之间的一致性相对较低（HER2 IHC得分1+，2+和3+是5％，15％和50％），将这些结果组合为UCS中的预后因素并不有效。相比之下，仅HER2 IHC得分就是I/II阶段UCS的预后因素。 HER2低组没有显示出特定的临床病理特征。由于HER2 IHC得分低于高级UCS是一个预测因素，因此使用HER2 IHC评分的HER2 IHC得分对UCS进行了分层，并且可以在不久的将来提出辅助治疗。
Abstract
Uterine carcinosarcoma (UCS) is uncommon high-grade endometrial cancer with limited treatment options. We evaluated the prognostic significance of human epidermal growth factor receptor 2 (HER2) expression and HER2 gene amplification within large cohorts of UCS, and clarify clinicopathologic characteristics of HER2-low UCS.We examined HER2 protein expression in 148 patients of UCS using in vivo diagnostic HER2 immunohistochemistry (IHC) kits and HER2 gene amplification using fluorescence in situ hybridization (FISH) in 72 patients.HER2 IHC score was evaluated according to the latest American Society of Clinical Oncology/College of American Pathologists criteria for gastric cancer, which was negative in 41 patients, low expression of 1+ was observed in 57 patients, and HER2 high expression was observed in 50 patients (2+ in 38 and 3+ in 12 patients). There was no significant statistical difference in clinicopathological characteristics based on HER2 protein expression status. HER2 negative and low expression compared to high expression revealed poor overall survival in stage I/ II. The concordance between IHC and FISH results were relatively low compared to other cancer types (HER2 IHC score 1+, 2+, and 3+ were 5%, 15%, and 50%), and combining these results was not efficient as a prognostic factor in UCS. In contrast, the HER2 IHC score alone was a prognostic factor in stage I/II UCS. HER2 low group did not show specific clinicopathologic features.Since the HER2 IHC score low in advanced UCS is a predictive factor, stratification of UCS using HER2 IHC score for HER2 IHC score low group and developing adjuvant therapy may be proposed in the near future.