Heterogeneity Of HER2 Positive Breast Cancer

Objective:To investigate the heterogeneity of recurrence and metastasis of HER2 positive breast cancer after modified radical mastectomy.Methods:From January 1,2006 to December 31,2017,1300 patients with HER2 positive breast cancer are diagnosed by pathology.Among them,101 patients with progression who has completed the standardized AC-TH treatment and the first recurrence and metastasis are selected.According to the hormone receptor group,analyze the disease-free survival and influencing factors,establish the prognosis risk model.The expression difference between primary and metastatic lesions is statistically analyzed.Kaplan Meier method is used to calculate the survival rate,drawing the survival curve and compare the survival rate.Log rank test method is used to analyze the factors that affect the disease-free survival rate by single factor and Cox multi factor model,screen the independent factors and risk coefficients that affect the disease-free survival rate,and substitute the number of risk coefficients of each factor into equation 9×(the maximum value of regression coefficient of each factor/prognostic regression coefficient)+1,and analyze the prognostic factors The prognosis risk model is established.Chi square test is used to analyze the differences between groups,and logistic test is used to analyze the influencing factors of the differences between groups.There is statistical difference in all test standards(P< 0.05).Results:1 Tumor heterogeneity in HER2 positive breast cancer patients affects prognosis.The disease-free survival time(P=0.001)and the disease-free survival rate of 2,3,4,5 years is also different(P=0.000,0.000,0.017,0.019).The 5-year disease-free survival rate of ER and PR positive is the highest.2 To establish the prognosis scoring model of patients with HER2 positive modified radical mastectomy.Single factor analysis of disease-free survival rate: stage,grade,number of lymph nodes involved(N),endocrine,ER,tumor diameter(T),PR(P=0.004,0.012,0.030,0.000,0.000).The independent factors are PR,N,T and endocrine(P=0.000,0.001,0.000,0.000).The risk coefficient of independent factors is substituted into the equation to establish the prognosis evaluation model.The model is statistically significant(P=0.000).3 The heterogeneity of HER2 positive primary and metastatic breast cancer.The expression of ER and PR positives,ER and PR negatives,ER positive PR negative are 30.1%,23.8% and 27.0% respectively.ER positive PR positive decreased(P=0.000);ER negative PR negative increased(P=0.000).ER positive PR negative increased,but there is no statistical significance(P=0.054).4 The difference of expression in primary and metastatic breast cancer is influenced by radiotherapy(P=0.025,P=0.039).Conclusions:1 HER2 positive breast cancer hormone receptor is different,disease-free survival is also different.The 5-year disease-free survival rate of ER and PR positives patients is the highest.2 To establish the prognosis scoring model of patients with HER2 positive breast cancer after modified radical mastectomy,and to accurately judge the prognosis and early intervention.3 The expression of hormone receptors in the primary and metastasis of HER2 positive breast cancer is different.