Relationship between HER-2 Status Changes and Clinicopathological Features in Breast Cancer Patients with Zero HER-2 Expression after Neoadjuvant Therapy

目的：调查HER-2零表达的乳腺癌患者新辅助治疗后HER-2表达状态改变与临床病理特征的关系。方法：纳入2017年1月至2020年1月在青岛大学附属医院乳腺病诊疗中心初次就诊的乳腺癌患者，对他们进行回顾性分析。根据化疗后HER-2状态分为HER-2状态不变的阴性组和HER-2状态改变的阳性组。分析HER-2状态改变与患者临床病理特征之间的联系。结果：纳入的367例患者新辅助治疗后阴性组共有248例，阳性组共有119例。采用χ2检验对患者的临床病理指标进行统计分析。结果显示与阴性组相比，阳性组病例中纯浸润性乳腺癌的比例更高。同时，组织学分级较低，ER阳性率较高，Ki-67小于等于14%的比例在阳性组中也高于阴性组，差异有统计学意义(P Objective: To investigate the relationship between the change of HER-2 expression status and clinicopathological characteristics in breast cancer patients with zero expression of HER-2 after neoadjuvant therapy. Methods: Patients with breast cancer who were initially diagnosed in the Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qingdao University from January, 2017 to January, 2020 were included in this retrospective analysis. According to HER-2 status after chemotherapy, the patients were divided into the HER-2 status unchanged negative group and the HER-2 status changed positive group. The relationship between HER-2 status and clinicopathological features was analyzed. Results: Among 367 patients, 248 were in the negative group and 119 were in the positive group after neoadjuvant therapy. The chi-square test was used to analyze the clinicopathological parameters of the patients. The results showed that compared with the negative group, the proportion of pure invasive breast cancer in the positive group was higher than that in the negative group. At the same time, the lower histological grade, the higher the ER positivity rate, and the proportion of Ki-67 less than or equal to 14% was also higher in the positive group than in the negative group, with statistically significant differences (P < 0.05). Logistic multivariate analysis showed that ER, Ki-67, histological type and histological grade were independent factors affecting the change of HER-2 status (P <0.05). Conclusions: Nearly 30% of breast cancer patients with HER-2 (0) show a change in HER-2 status after NAT, and patients with HER-2 status transition show different clinicopathological features from those without transition.