Influencing Factors And Prediction Of Neoadjuvant Therapy For HER-2-Positive Breast Cancer

Objective Neoadjuvant targeted therapy plays an important role in the treatment of Human epidermal growth factor receptor 2（HER-2）positive breast cancer.The aim of this study was to explore the predictive significance of immunohistochemistry（IHC）and fluorescence in-situ hybridization（FISH）test results and other clinicopathological information on HER-2 positive breast cancer in neoadjuvant targeted therapy in the domestic population.Methods This study retrospectively analysed the clinical and pathological data of 112HER-2 positive nonspecial type invasive breast cancer patients with neoadhuvant targeted therapy in the Second Hospital of Anhui Medical university and Xijing Hospital of Air Force Military Medical University from January 1,2019 to September30,2020.Analysis the correlation between the results of IHC and FISH as well as other clinicopathological data including age,estrogen receptor（ER）,progesterone receptor（PR）,neoadjuvant chemotherapy regimen and pathological complete response（p CR）of neoadhuvant targeted therapy.Result ER（x~2=6.278,p=0.012）,PR（x~2=7.099,p=0.008）and anti-HER-2 treatment regimen（x~2=13.516,p<0.001）are related to p CR,and the differences are statistically significant.In the multivariate regression analysis,the factors that adjusted the ER,PR and anti-HER-2 treatment regimens,the p CR rate of patients treated with the dual target regimen against HER-2 was higher（OR=5.059,95%CI:2.052-12.468,p<0.001）,the p CR rate of ER-negative patients was higher than that of positive patients（OR=0.309,95%CI:0.131-0.724,p=0.007）.In FISH detection,the ratio of HER-2/chromosome 17 centromere（HER-2/CEP17）（Z=-4.973,p<0.001）and the ratio of HER-2/cell number（Z=-10.838,p<0.001）were correlated with the p CR rate,the difference is statistically significant.Conclusion Both IHC and FISH are important HER-2 detection methods in breast cancer.The detection of HER-2/CEP17 ratio and HER-2/cell number by FISH in HER-2 positive breast cancer patients is of great significance for predicting efficacy in neoadjuvant targeted therapy.Hormone receptor status and anti-HER-2 therapy regimens are also important factors affecting the efficacy.