| Background:According to the latest global cancer burden data released by the international agency for research on cancer of the World Health Organization in 2020,there are 2.26 million new cases of breast cancer in the world,which has surpassed lung cancer and become the largest cancer in the world[1].The morbidity of new breast cancer patients in China is about 304thousand per year,accounting for 17.1%of female cancer[2].The incidence of breast cancer tends to be younger in China,which is the most common cause of death for women under 45 years old[3].As a special subtype of breast cancer,triple negative breast cancer（TNBC）referstonegativeestrogen-receptor（ER）,progesterone-receptor（PR）and human epidermal growth factor receptor-2（HER-2）,which accounts for about 10%-20%in breast cancer[4].It tends to highly invasive local recurrence and distant metastasis.Axillary lymph node metastasis is the most common form of breast cancer metastasis,which is closely related to the tumor stage,treatment and prognosis.Ki-67,proliferative nuclear antigen,is a kind of protein in the nucleus,which indicates proliferative activity of tumor cells.HER-2 is a transmembrane glycoprotein with tyrosine kinase activity,which can mediate cell growth and differentiation.HER-2 as a proto oncogene is amplified in about 20-30% of breast cancer[5].In TNBC,the relationship between HER-2,Ki-67 and axillary lymph node metastasis is still unclear.Objective:1.To investigate the relationship between HER-2 expression and axillary lymph node metastasis in TNBC.2.To explore the influence factors of HER-2 expression status on axillary lymph node metastasis in TNBC.3.To investigate the correlation between Ki-67 expression and axillary lymph node metastasis in TNBC.4.To investigate the correlation between Ki-67 expression and axillary lymph node metastasis under different status of HER-2 expression.Method:We collected 254 cases of TNBC patients with complete pathological data from January 2015 to March 2021 in the department of breast surgery,the second hospital of Jilin University.We divided the expression status of HER-2 into HER-2（-）,HER-2（+）and HER-2（++）without FISH amplification according to the results of immunohistochemistry and fluorescence in situ hybridization（FISH）,and there were 105 cases in HER-2（-）,82 cases in HER-2（+）and 67 cases in HER-2（++）.According to the CSCO guidelines and the median of the study sample,30%and 60%were taken as the cut-off values of Ki-67.SPSS 26.0 software was used for statistical analysis,chi square test for comparison between groups,Spearman rank correlation test for correlation,binary logistic regression analysis for risk factors of axillary lymph node metastasis,p<0.05 was statistical significance.Result:1.In TNBC,different HER-2 expression status was associated with axillary lymph node metastasis(p HER-2（+）=0.004,p HER-2（++）=0.002).2.In TNBC,HER-2 expression was positively correlated with axillary lymph node metastasis（r=0.210,p=0.001）.3.In TNBC,the status of HER-2 was associated with axillary lymph node metastasis when the patients were older than 52 years or the tumor diameter was larger than 2cm(page=0.002,ptumor diameter=0.001).4.In TNBC,Ki-67 expression was not related to axillary lymph node metastasis,whether Ki-67 was classified as high,medium and low expression by 30%and 60%or Ki-67 was regarded as a continuous variable（p>0.05）.5.In TNBC,the expression of Ki-67 was not associated with axillary lymph node metastasis under different status of HER-2 expression status(p HER-2（+）=0.472,p HER-2（++）=0.476).Conclusion:1.In TNBC,the status of HER-2 expression can be used as a predictive factor for the metastasis of axillary lymph nodes.2.When the age is more than 52 years old or the tumor diameter is more than 2cm,patients with axillary lymph node metastasis may occur according to the different status of HER-2 expression.3.In TNBC,Ki-67 can not be used as a predicting parameter for axillary lymph node metastasis. |
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