| Objective: To compare and analyze the differences in age distribution,menstrual status,HR,Ki-67 expression level,histological grade,tumor size,lymph node metastasis,distant metastasis and other clinical characteristics between HER2-low and HER2-0 breast cancer.To investigate the effect of these two factors on the efficacy and prognosis of neoadjuvant chemotherapy.Methods:(1)The expression relationship between HER-2,ER and PR was analyzed at the molecular level through the breast cancer transcriptome data samples downloaded from the TCGA database.The differences in clinicopathological characteristics between HER2-low and HER2-0 in the TCGA cohort were further analyzed,and compared with the data of our center for verification.(2)The general clinical pathologic data and curative effect of neoadjuvant chemotherapy Follow-up data of 405 patients form January 2017 to December2021 by Affiliated Hospital of Youjiang Medical University for Nationalities treated diagnosed with breast cancer were collected.(3)The differences of clinicopathological characteristics between HER2-low and HER2-0 were compared and analyzed.The similarities and differences of pCR rate between the two groups of neoadjuvant chemotherapy and the correlation of prognosis were analyzed.The results were compared with TCGA data analysis.Results:(1)TCGA database analysis showed that the protein and m RNA expression levels of ER and PR were higher in breast cancer patients with HER2-low.The gene expression levels of ER and PR were positively correlated with the gene expression level of HER-2.(2)A total of 405 female breast cancer patients were enrolled in the study,ranging in age from 24 to 80 years(median 49 years).Among them,284 patients(70.1%)had HER2-low expression and 121 patients(39.9%)had HER2-0 expression.The positive rate of ER was higher(88.7%vs69.4%,P<0.0001),PR positive rate was also higher(71.1% v57.0%,P=0.006).There were no significant differences in age,menstrual status,tumor size,lymph node metastasis,distant metastasis at initial diagnosis,histological grade and Ki-67 expression intensity between the two groups(P>0.05).(3)The pCR rate of HER2-low expression group was significantly lower than that of HER2-0 expression group(7.5%vs33.3%,P=0.02).(4)the3-year recurrence or metastasis rate in the HER2-low expression group was significantly lower than that in the HER2-0 expression group(4.9%vs13.1%)(P=0.018).(5)K-M survival analysis showed that there was no significant difference in DFS between HER2-0 expression group and HER2-low expression group(P=0.420).The three-year DFS rate also did not differ between the HER2-0 and HER2-low groups(P=0.250).Conclusion:(1)The HR positive rate of patients with HER2-low expression is significantly higher than that of patients with HER2-0 expression,and the proportion of Luminal breast cancer is higher,while the proportion of TNBC breast cancer is lower.(2)The pCR rate of neoadjuvant chemotherapy in HER2-low breast cancer was lower than that in HER2-0 breast cancer.Lymph node metastasis,histological grade and hormone receptor expression were independent influencing factors of pCR rate.(3)The 3-year recurrence or metastasis rate of HER2-low breast cancer patients is significantly lower than that of patients with HER2-0 expression,but there is no significant difference in DFS between the two groups.The difference in long-term survival between the two groups needs further observation.(4)The results of this study showed that HER2-low breast cancer has certain clinicopathological characteristics,but more molecular and gene expression evidence is still needed to support it as a new subtype of breast cancer. |
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