Objective: To investigate the relationship between her2, ki67, EGFR expression and the biological behavior of breast cancer and its value in predicting recurrence and metastasis. Methods: 90 breast cancer patients admitted to our hospital from May 2019 to May 2021 were selected to analyze the relationship between her2, ki67, EGFR positive expression and age, histological staging, histological grading, clinical stage, lymph node metastasis, the presence of invasion of the vasculature, and the presence of invasion of nerves, comparing her2, ki67, and EGFR concentrations in patients with recurrent metastases versus those without recurrent metastases, Logistic regression models were developed by multifactorial analysis, and the diagnostic efficacy of the model was assessed using ROC curves. Results: Positive ki67 expression was associated with age, histological grade, and lymph node metastasis; the higher of the rate of ki67 positivity in patients aged ≥ 45 years, with higher histological grade, and with lymph node metastasis(P<0.05). her2 positive expression and EGFR positive expression were associated with histological grade and lymph node metastasis; the higher of the histological grade and the higher of the rate of her2 positive expression and EGFR positive expression in patients with lymph node metastasis(P<0.05). her2, ki67, and EGFR are not related to histological staging, clinical stage, or whether they invade the vasculature(P>0.05). Serum her2, ki67 and EGFR levels were higher in the recurrent metastasis group than in the non-recurrent metastasis group(P<0.05). Serum her2, ki67, and EGFR were all independent risk factors for breast cancer recurrence and metastasis(P<0.05). The sensitivity and specificity of serum her2, ki67 and EGFR alone and the combination of the three tests for the diagnosis of recurrent breast cancer metastasis were 83.30%, 75.00%, 53.30%, 95.00%, 66.70%, 75.00%, 86.70%, 83.30%, respectively. The diagnostic value of serum her2 alone for the detection of recurrent breast cancer metastasis was higher than the other two tests alone and the combination of the three tests was higher than the other single tests(P<0.05). Conclusion: her2 contributes to breast cancer lymph node metastasis, plays an important role in the development of breast cancer, and is expected to be an important indicator of biological behavior and prognosis assessment of breast cancer. her2 combined with ki67 and EGFR can effectively improve the sensitivity and specificity of the diagnosis of breast cancer recurrence and metastasis. |
[1] 张杰, 宋耀国, 史丽民, 等.乳腺癌前哨淋巴结转移的相关因素分析[J].现代医学, 2019, 47(3):320-324.
[2] 王超群, 王艳, 黄必飞, 等.表皮生长因子受体1蛋白表达与乳腺癌分子分型及激素受体状态的关系[J].中华内分泌外科杂志, 2018, 12(5):358-361.
[3] 杨雅洁, 孙艳花.乳腺癌组织中HER2的表达及其与临床病理特征的关系[J].南昌大学学报(医学版), 2018, 58(1):55-59.
[4] 张功学, 齐峰, 丁凯, 等.Ki67, Her2及EGFR在乳腺癌组织中表达的临床意义[J].标记免疫分析与临床, 2018, 25(3):85-89.
[5] 河南省肿瘤医院乳腺癌诊疗共识专家团队, 刘真真, 李连方, 等.河南省肿瘤医院临床早期乳腺癌手术治疗专家共识[J].中华肿瘤防治杂志, 2019, 26(24):15-19.
[6] 王文林.乳腺癌相关性疼痛综合征的病机与证治[J].东南大学学报(医学版), 2020, 39(4):547-550.
[7] 许素真, 陈淑如.乳腺癌保乳术联合新辅助化疗前后癌组织VEGF、EZH2、p53蛋白表达的变化[J].现代医学, 2019, 47(1):60-62.
[8] 朱晓莹, 林洁, 王兴枝子, 等.IHC与FISH检测浸润性乳腺癌患者HER2蛋白表达和基因扩增的差异性分析[J].现代肿瘤医学, 2021, 29(8):1320-1324.
[9] 姜聪, 黄元夕.系统免疫炎性反应指数对乳腺癌新辅助化疗病理完全缓解的预测作用及其与p53的关系[J].肿瘤防治研究, 2020, 47(10):756-760.
[10] 何慧君, 欧阳翠雯, 潘小梅.三阴性乳腺癌组织hMLH-1, Ki-67表达水平以及雄激素水平与其生物学行为的关系分析[J].现代医院, 2018, 18(8):1191-1193, 1197.
[11] 王晓, 蒋燕妮, 朱丽钰, 等.全容积表观扩散系数直方图定量分析术前预测不同亚型乳腺癌新辅助化疗后病理完全缓解的价值[J].中华放射学杂志, 2020, 54(4):338-344.
[12] HU Y, GU R, ZHAO J, et al.Prognostic significance of Ki67 in Chinese women diagnosed with ER +/HER2 breast cancers by the 2015St.Gallen consensus classification[J].Bmc Cancer, 2017, 17(1):28.
[13] BADVE S S, LI L, THORAT M A, et al.Differential gene expression analysis and correlation with outcome in HER2-positive metastatic breast cancer treated with HER2-targeted therapy.[J].J Clin Oncol, 2010, 28(15):1036.
[14] 刘现义, 王晓春, 张丹丹, 等.LRP16、Ki67及EGFR表达与乳腺癌的临床病理因素及预后的关系探讨[J].中国地方病防治杂志, 2017, 32(4):456-456.
[15] 杨宇峰, 庾建中, 林思园, 等.乳腺癌原发肿瘤和复发肿瘤间ER、PR和HER-2表达不一致及其对患者生存的影响[J].临床与实验病理学杂志, 2019, 35(3):21-26.
[16] 梁翠珊, 崔运能, 杨伟超, 等.基于T2WI影像组学标签预测乳腺癌人表皮生长因子受体2表达状态[J].中国医学影像技术, 2019, 35(4):80-84.
[17] 彭理, 赵佳琳, 赵大春, 等.免疫组织化学指标在乳腺癌原发灶和复发转移灶之间的表达差异[J].中国医学科学院学报, 2019, 41(5):673-677.
[18] 楼立新, 王荣飞, 林恒军, 等.46例乳腺癌组织Ki-67表达与ER、PR、CerbB-2表达水平、临床病理特征及5年生存率关系的回顾性分析[J].中国医刊, 2017, 52(4):40-43.
[19] 周南, 曾宏桥, 刘首红, 等.ABVS观察乳腺癌新辅助化疗肿瘤体积变化与HER2表达的相关性[J].中国超声医学杂志, 2018, 34(5):413-417.
[20] 陆景润, 肖斌, 邓淳, 等.Casitas B系淋巴瘤原癌基因在乳腺癌组织中的表达水平及其临床预后分析[J].医学研究生学报, 2020, 33(2):43-48.
[21] 任玉琳, 张丽, 佟仲生.不同激素状态的HER2阳性晚期乳腺癌复发转移特征及生存分析[J].肿瘤防治研究, 2019, 46(1):43-50. |