Predictive Value Of HER2 Low Expression On The Outcome And Recurrence Of Metastasis In Triple Negative Early/locally Advanced Breast Cancer Patients

Objective:To investigate the predictive value of low expression of human epidermal growth factor receptor 2(HER2)on the outcome and recurrence of metastasis in patients with triple-negative early/locally advanced breast cancer.Method:Retrospective analysis of clinical data of 98 triple negative breast cancer patients who received neoadjuvant chemotherapy in our hospital from March 2018 to March2020,analysis of clinicopathological characteristics of 98 triple negative breast cancer patients with different HER2 expression levels,binary logistic regression analysis of clinicopathological characteristics and complete remission rate of 98 triple negative breast cancer patients,and COX regression analysis of 98 triple negative breast cancer patients with different HER2 expression levels and prognosis.Screening patients with triple-negative early/locally advanced breast cancer based on the SEER database.A total of 5645 patients’ data were retrieved from the SEER database by SEER*Stat8.4.0.1 software.The clinicopathological features and complete response rate of 3406 patients with triple-negative early/locally advanced breast cancer were analyzed by binary Logistic regression,and OS was analyzed by multivariate factors.Result:Among the 98 patients with triple negative breast cancer,47 patients(47.96%)had HER2 expression of 0,22 patients(22.45%)had HER2 expression of 1(1+),29patients(29.59%)had HER2 expression of(2+)and FISH(-),and 51 patients(52.04%)had low HER2 expression,the rate of axillary lymph node metastasis in patients with low HER2 The rate of axillary lymph node metastasis was higher in patients with low HER2 expression level than in patients with 0 HER2 expression,and the proportion of patients with postoperative lymph node staging of N0,N2,was higher compared to those with 0 HER2 expression(all P<0.05).Comparison of age,menopause,clinical T-stage,androgen receptor(AR)status,and TNM stage among patients with different HER2 expression levels(all P>0.05);comparison of complete remission rates among patients with different age,menopausal status,and AR status(all P>0.05);and comparison of complete remission rates among patients with different clinical T-stage and HER2 expression levels(all P<0.05).Further multi-factor binary logistic regression analysis showed that clinical T-stage and HER2 expression level were all influencing factors for complete remission rate(OR=0.352,0.593,both P<0.05),and clinical stage of c T1 and low HER2 expression level were influencing factors for complete remission of patients(OR=5.001,0.617,both P<0.05);HER2 expression level,complete remission and postoperative lymph node stage were all influencing factors for tumour-free survival,with patients in non-complete remission after neoadjuvant chemotherapy,high HER2 expression level and higher postoperative lymph node stage having a worse prognosis(HR=2.799,0.199,0.297,all P<0.05).Among 3406 patients with triple-negative early/locally advanced breast cancer in the SEER database,1659 patients had complete response,accounting for 48.71%of the total,and 1747 patients had incomplete response,accounting for 51.29% of the total.Age ≥50 years old,clinical stage CT3-4,and postoperative lymph node staging may be risk factors for complete response in patients with triple-negative early/locally advanced breast cancer.Further multivariate binary Logistic regression analysis showed that age and postoperative lymph node staging were influencing factors for complete response rate(P<0.05).OS of patients with triple-negative early/locally advanced breast cancer was(65.06±30.723)months.Univariate analysis found that clinical T stage may affect OS of patients with triple-negative early/locally advanced breast cancer.Further multiple linear regression results showed that,Postoperative lymph node staging was an important factor affecting OS in patients with triple-negative early/locally advanced breast cancer(P<0.05).Conclusion:Clinical staging of triple-negative breast cancer patients with c T1 and low HER2 expression levels are influential factors for patients in complete remission,and patients in non-complete remission after neoadjuvant chemotherapy,with high HER2 expression levels and higher postoperative lymph node staging have a poorer prognosis.HER2 expression levels can be used as a predictor of outcome and recurrent metastasis in patients with triple-negative early/locally advanced breast cancer.At the same time,patient age,clinical T-stage and postoperative lymph node stage had certain effects on the complete response rate of patients with triple-negative early/locally advanced breast cancer,and postoperative lymph node stage was an important factor influencing OS in patients with triple-negative early/locally advanced breast cancer(P<0.05).