Analysis Of Updated Guidelines For HER2 Detection In Breast Cancer And Correlation Studies Of HER2 Expression,Different Ploidy Of Chromosomes 17 And Clinical Pathological Features

Objective: Compare the differences between the 2018 and 2014 HER2 testing guidelines for breast cancer,and compare clinical applicability;to investigate the relationship between HER2 expression and other clinicopathological features and prognosis;analysis of clinicopathological features and prognosis of patients with different chromosome 17 ploidy.Method:1.Screening of the Fourth Hospital of Hebei Medical University from October 2014 to October 2017 for histopathological diagnosis of invasive breast cancerand who did not receive any treatment before surgery,a total of3483 cases.Collecting their clinical pathological data and follow up.To study the differences of the 2014 HER2 testing guideline and updated guideline,and study the differences between clinical treatment and prognosis in patients with different cases and compare the clinical significance of the two guides.To analyze the relationship between HER2 expression and clinicopathological features and prognosis.2.According to HER2 detection guideline for breast cancer,if immunohistochemistry result of HER2 is 2+,fluorescence in situ hybridization(FISH)test is required to determine HER2 expression,selecte patients whose result was 2+ and did FISH testing.1419 patients were detected,group them based on chromosome 17 copy number,to analyze the differences in clinicopathological features and prognosis of chromosome 17 between different ploids.Resualts:1.Comparison of HER2 interpretation and applicability analysis of IBC patients.A total of 3483 patients with IBC were collected,11 males and 3472 females,age 20 to 78 years old.3206 cases were successfully followed up,recurrence and metastasis in 97 cases,19 deaths,survival rate is 99.41%,survival time was 1 to 39 months,disease-free survival time was 1 to 39 months.The results of the 2014 edition guideline: HER2 was negative in 2505 cases,positive in 885 cases,and suspicious in 93 cases.The results of the updated guideline results: HER2 negative in 2601 cases,positive in 882 cases,suspicious in 0 cases.In the 2014 version of the HER2 test guide,3 cases of positive and 93 cases of suspicious patients were changed to negative after the guideline updated.There was a significant difference in interpretation results between the two versions of the guideline(P<0.05).Kaplan Meier survival analysis showed that whether these changed patients receiving anti-HER2therapy have no significant difference,the difference was not statistically significant(P>0.05).2.Analysis of correlation between HER2 expression and clinicopathological features.The updated guideline interpretation results revealed that HER2 was negative in 2601 cases and positive in 882 cases.After research,Ki67 expression,clinical stage,tumor maximal diameter,lymph node metastasis,and vascular tumor thrombus were positively correlated with HER2 expression,negative correlation between ER,PR expression and HER2 expression,the difference was statistically significant(P<0.05).Gender,age,nerve invasion was not relatedand with HER2 expression,the difference was not statistically significant(P>0.05).The survival analysis showed that the prognosis of HER2-negative group and HER2-positive-ont-anti-HER2 treatment group were better than the HER2-positive-anti-HER2 treatment group,the difference was statistically significant(P<0.05).3.Clinicopathological characteristics and prognosis of patients with different ploidy chromosome 17.In the 1419 patients,223 were multibody and 19 monomer;129 caseswere HER2 positive and 1048 were HER2 negative in the normal ploidy group.The tumor histological grade,lymph node metastasis rate,tumor thrombus,Ki67 high expression rate,clinical stage in multibody group were higher than HER2 negative group,and the prognosis was poor.ER,PR positive rate in multi-body group was higher than in the HER2 positive group,the difference statistically significant(P<0.05).The high expression rate of Ki67,lymph node metastasis,and histological grade were lower in the monomer group than in the HER2 positive group and multibody group(P<0.05).Since there were fewer HER2-positive patients in the monomer group,the differences in anti-HER2 treatment efficacy between the aneuploid group and the normal ploidy group were not analyzed.Conclusions:1.Updated breast cancer HER2 testing guideline has better applicability in clinical practice.2.HER2 positive breast cancer patients have poor clinicopathological features and prognosis,and anti-HER2 therapy can improve their prognosis.3.The histological grade,lymph node metastasis,vascular tumor thrombus,Ki67 expression,and clinical stage of chromosome 17 polymorphism were higher than that of HER2 negative group.The positive rate of ER and PR was higher than that of HER2 positive group,and the prognosis of multibody group was better than that of HER2.Patients in the negative group were poor.4.On chromosome 17,the lymph node metastasis rate,tumor histological grade,and Ki67 expression were lower in HER2 positive group and multibody group than in HER2 negative group.