HER2不同表达状态对三阴性乳腺癌新辅助化疗疗效及预后的影响OA

Objective To explore the impact of HER2 expression status on the efficacy of neoadjuvant chemotherapy(NAC)and prognosis in patients with triple-negative breast cancer(TNBC).Methods A retrospective analysis was conducted on 189 TNBC patients who underwent NAC followed by surgery at Taihe Hospital from January 2017 to December 2021.Pa-tients were stratified into HER2-Zero group(n=98,IHC 0)and HER2-Low group(n=91,IHC 1+or 2+/FISH-).The clinicopathological features,pathological complete response(pCR)rates,and survival outcomes were compared between the two groups,and prognostic factors were identified.Results Compared to the HER2-Low group,the HER2-Zero group exhibited lower body mass index(BMI),histological grades,and Ki-67 levels,as well as reduced positivity for androgen receptor(AR)(all P＜0.05);however,there was no difference in pCR rates between the two groups(P＞0.05).Multiva-riate logistic regression analysis indicated that clinical T stage,axillary lymph node status,and Ki-67 levels were identified as independent predictors of pCR(P＜0.05).With a median follow-up of 47 months,the HER2-Zero group demonstrated superior disease-free survival(DFS)(P＜0.05),although the overall survival(OS)did not differ between the groups(P＞0.05).Furthermore,multivariate analysis identified pCR as an independent predictor of DFS and OS(P＜0.05).Sub-group analysis revealed that the patients who achieved pCR had better DFS than those with non-pCR in HER2-Low group(P＜0.05).Conclusion The clinicopathological characteristics of TNBC patients undergoing NAC vary according to HER2 expression status.Although HER2 status does not affect the efficacy of NAC,pCR is strongly associated with DFS in the HER2-Low subgroup,suggesting that HER2 expression stratification may provide a novel approach for prognostic evaluation in TNBC.