HER2阴性或低表达为I/II期子宫肉瘤患者的不良预后因素
HER2-negative or low expression as an unfavorable prognostic factor in patients with stage I/II uterine carcinosarcoma
DOI 原文链接
用sci-hub下载
如无法下载，请从 Sci-Hub 选择可用站点尝试。
影响因子:3.7
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
DOI:
10.3802/jgo.2025.36.e14
摘要
子宫肉瘤（UCS）是一种少见的高恶性度子宫内膜癌，治疗选择有限。本研究评估了在大规模UCS队列中人类表皮生长因子受体2（HER2）表达及HER2基因扩增的预后意义，并阐明HER2低表达UCS的临床病理特征。我们采用体内诊断性HER2免疫组化（IHC）试剂盒对148例UCS患者的HER2蛋白表达进行检测，并对72例患者进行HER2基因扩增检测（荧光原位杂交FISH）。HER2 IHC评分依据最新的美国临床肿瘤学会/美国病理学会（ASCO/CAP）胃癌指南评估，结果显示41例为阴性，57例表现为1+低表达，50例为高表达（38例为2+，12例为3+）。不同HER2蛋白表达状态的临床病理特征差异无统计学意义。HER2阴性和低表达组在I/II期表现出较差的总生存率。IHC与FISH检测结果的一致性相对较低（HER2 IHC 1+、2+和3+的比例分别为5%、15%和50%），两者结合作为预后指标的效果不佳。而单纯HER2 IHC评分在I/II期UCS中是一个预后因素。HER2低表达组未表现出特定的临床病理特征。鉴于HER2 IHC低表达在晚期UCS中是一个预测因素，可在未来通过HER2 IHC评分进行UCS分层，并开发辅助治疗策略。
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.