HER2用于评估非肌层浸润性膀胱癌复发及进展的研究

摘要

目的 探讨HER2表达用于评估非肌层浸润性膀胱癌( NMIBC)复发及进展的意义. 方法 采用免疫组化染色的方法,检测301例NMIBC患者肿瘤HER2的表达情况,并且对所有患者肿瘤复发及进展情况进行随访. 结果 肿瘤数目(单发、数目>1;[HR]:1.91,P=0.001)〗、肿瘤大小( <3cm、≥3cm;[HR]:2.20,P<0.0001)、肿瘤分期(Ta、T1;[HR]:2.08,P=0.001)、肿瘤分级(G1、G2、G3;[HR]:1.71,P=0.041)与膀胱癌复发相关;而肿瘤大小(<3 cm、≥3 cm;[HR]:2.50,P=0.015)、肿瘤分期(Ta、T1;[HR]:3.68,P=0.007)、肿瘤分级(G1、G2、G3;[HR]:2.72,P=0.018)、是否伴发原位癌([HR]:3.33,P=0.008)、HER2(阴性、阳性;[HR]:2.36,P=0.030)均可影响膀胱癌进展. HER2表达阴性的患者与HER2表达阳性患者相比,膀胱癌进展至肌层浸润性的风险明显降低. 结论 HER2表达可作为预测NMIBC进展的指标,HER2阳性患者疾病进展风险更大.%Objective We investigated the relationship between HER2 expression and its prognostic signifi-cance in patients with Non-muscle invasive bladder cancer ( NMIBC ) .Material and methods 301 patients treated by transurethral resection of the bladder tumor were histopathologically confirmed to be NMIBC.Her-2 expression was evaluated by immunohistochemistry ( ICH) and scored for intensity and area of staining.Tumor recurrence and progression were followed-up in all patients.Results In multivariable analyses, tumor number [(single;number >1) ([HR]:1.91, P=0.001)], tumor size [(<3 cm,≥3 cm) ([HR]:2.20, P<0.0001)], tumor stages [(Ta, T1) ([HR]:2.08, P=0.001)], tumor grade [(G1, G2,G3) ([HR]:1.71, P=0.041)] associate the recurrence of NMIBC.And tumor size [(<3 cm,≥3 cm) ([HR]:2.50, P=0.015)], tumor stages [(Ta, T1) ([HR]:3.68, P=0.007)], tumor grade [(G1, G2, G3) ([HR]:2.72, P=0.018)], carcinoma in situ [(no ,yes) ([HR]:3.33, P=0.008)], HER2 [(negative , posi-tive) ([HR]:2.36, P=0.030)] associate the progression of NMIBC .The negative expression of HER2 asso-ciates the lower risk of bladder cancer's progression to muscle invasion.Conclusions HER2 positivity is prog-nostic for predicting progression to muscle invasion in NMIBC.The NMIBC patients with HER2 positive have higher possibility to progression.