The Prognostic Significance Of HER2Differential Expression In Primary Tumor And Metastatic Lymph Node Of Invasive Breast Cancer

Objective To study the prognostic significance of HER2differential expression in primary tumor and metastatic lymph nodeof invasive breast cancer.Methods The medical records of90patients who had been diagnosed as invasive breast cancer in2009of our hospital were reviewed retrospectively. HER2expression in primary tumor and metastatic lymph node were detected using immuneohistochemistry andfluorescence in situ hybridization (FISH) analysis. The outcomes ofpatients were followed strictly. The differential expression of HER2in primary tumor and metastatic lymph node and its prognostic significance were analyzed statistically.90cases of breast cancer weredivided into four groups: HER-2negative in the primary tumor andmetastatic lymph node, HER-2negative in the primary tumor and then turned into positive in the metastatic lymph node,HER-2positive then turned into negative in the metastatic lymph node, HER-2positive in the primary tumor and metastatic lymph node. As for the fo ur groups, clinical characteristic and survival differences were studied. Survival analysis was performed using Kaplan-Meier method and tested by Log-rank, and prognosisanalysis of multiple factors was carried out by using Cox Proportional Hazard Model.Results1、5cases in total patients showed differential expression of HER2in primary tumor and metastatic lymph nodes, among them,3(3.3%) cases expressed positive of HER2in primary tumorwhile negative in the metastatic lymph nodes, however, the expression of HER2in the other two cases(2.2%) was reversed.The differential expression of HER2between primary lesion and metastatic lymph nodes tumor was not significan t (P＞0.05)2、The differentialexpression of HER-2in primary lesion and recurrent/metastatic tumor showed a significant correlate on with the5-year disease free survival (DFS)(P<0.05).The5-year DFS of HER2positive and negateve cases in primary tumor was respectively76.7%and88.3%. In metastatic lymph node,5-year DFS of HER-2positive patients was79.7%and HER-2negative ones was86.9%.3、The primary focus of the HER-2over expression and Inlymph node metastasis in HER-2negative expression was3patients, and their5year disease free survival rate was50%. The other2patients of Primary HER-2negative expression and inmetastatic lymph node positive expression5year diseasefreesurvival rate was33.3%. They both had relatively poor5yeardisease free survival rate (56%).Conclusion1.HER-2is an independent prognostic indicator inpatients with breast cancer, and its closely related to the behavior of the tumor and prognostic of clinical.2.The differential expression of HER-2in primary lesion and recurrent/metastatic tumor was not statistically significant. The lack ofenough samples may affect the the accuracy of results.3.The expression of HER-2in primary lesion and metastatic lymph nodes showed differences, which reflected the heterogeneityof breast cancer. Besides, differential expression of HER-2in patients correlated to the5-year DFS, HER-2expression changed frompositive to negative had a relatively poor5-year DFS.