The Expressions Difference And Their Significance Of HER-2 Between Primary And Recurrence/metastases In Breast Cancer

Objective To study the expression difference of Epidermal Growth Factor Receptor II (HER-2 receptor) between primary lesion and recurrence/metastasis of breast cancer, and its influence on prognosis of advanced breast cancer patients.Methods Retrospective analysis was performed for 76 cases of breast cancer recurrence from Jan. 2002 to Dec. 2008, the HER-2 expression between of primary lesion and recurrence/metastasis was detected by immunohistochemistry, and prognosis was studied at clinical followed-up. Statistical methods were utilized to analyze the difference of HER-2 expression between primary lesion and recurrence/metastasis, as well as prognosis factors. And according to the expression difference, the 76 cases were divided into four groups: HER-2 negative, HER-2 negative then turned to positive, HER-2 positive then turned to negative, HER-2 positive. As for the four groups, clinical characteristic and survival differences were studied. Survival analysis was performed using Kaplan-Meier method and tested by Log-rank, and prognosis analysis of multiple factors was carried out by using Cox Proportional Hazard Model.Results 1, In 76 breast cancer patients, the HER-2 expression of primary lesion and recurrence/metastasis of breast cancer was inconsistent in 25cases(32.9%), the primary lesion was positive but recurrence/metastasis negative was 7(9.2%); the primary lesion was negative but recurrence /metastasis positive was 18(23.7%).The expression difference of Epidermal Growth Factor Receptor II (HER-2 receptor) between primary lesion and recurrence/metastasis exists(P<0.05).2,The expression differences of HER-2 in primary breast cancer and recurrence/metastatic breast cancer were of significantly different in statistics on survival rate(P <0.05),Start from diagnosed with breast cancer the 5-year survival rate was 22.0%,41.4% respectively, start from diagnosed with recurrence/metastatic the 5-year survival rate was 13.6%,23.6% respectively. 3,Although the clinical features of four groups were no significantly different at clinical stages, recurrent parts, ER, PR and endocrine therapy at the time of recurrence/metastasis diagnosis(P >0.05). Survival analysis shows the patient whose primary lesion was positive but recurrence /metastasis negative, gained the better 5-year survival rate(26.7%), and the patient whose primary lesion was negative but recurrence/metastasis positive got the worse 5-year survival rate 14.3%.Conclusion 1, HER-2 is the influential clinical molecular indicator for breast cancer, and the clinical significance is related to biological behaviors and clinical prognosis of tumor.2, The expression between primary lesion and recurrence/metastasis is different, which indicates the heterogeneity of breast cancer. The expression difference is related to survival, the survival rate of expression of HER-2 positive turned to negative is better, and negative turned to positive is worse.3The expression of HER-2 receptor between primary lesion and recurrence/metastasis is different, so the expression level of HER-2 in recurrence/metastasis should be taken into account when Trastuzumab is used to treat advance breast cancer.