her2、ki67、EGFR表达与乳腺癌生物学行为的关系及其预测复发转移的ROC分析-现代医学

her2、ki67、EGFR表达与乳腺癌生物学行为的关系及其预测复发转移的ROC分析

单位：陕西省人民医院肿瘤外科, 陕西西安 710068

分类号：R737.9

出版年·卷·期（页码）：2022·50·第十期（1248-1255）

摘要：

目的：探讨表皮生长因子受体2（her2）、ki67、表皮生长因子受体（EGFR）表达与乳腺癌生物学行为的关系并探讨其对预测复发转移的价值。方法：选取我院2019年5月至2021年5月收治的90例乳腺癌患者，分析her2、ki67、EGFR阳性表达与年龄、组织学分型、组织学分级、临床分期、淋巴结转移、有无侵犯脉管、有无侵犯神经等的关系，比较复发转移与未复发转移患者her2、ki67、EGFR浓度，通过多因素分析建立Logistic回归模型，采用受试者工作特征（ROC）曲线评估模型诊断效能。结果：ki67阳性表达与年龄、组织学分级、淋巴结转移有关；年龄≥45岁、组织学分级较高、有淋巴结转移的患者ki67阳性率高（P<0.05）。her2和EGFR阳性表达与组织学分级和淋巴结转移有关；组织学分级越高、有淋巴结转移的患者，her2和EGFR阳性表达率高（P<0.05）。her2、ki67、EGFR与组织学分型、临床分期、是否侵犯脉管无关。复发转移组血清her2、ki67、EGFR水平均高于未复发转移组（P<0.05）。血清her2、ki67、EGFR均是影响乳腺癌复发转移的独立危险因素（P<0.05）。血清her2、ki67、EGFR分别诊断及三者联合诊断乳腺癌复发转移的灵敏性、特异性分别为83.30%、75.00%，53.30%、95.00%，66.70%、75.00%，86.70%、83.30%，血清her2单独检测乳腺癌复发转移的诊断价值高于其他两项单独检测，三者联合检测高于其他单项检测（P<0.05）。结论：her2会促使乳腺癌淋巴结转移，在乳腺癌的发生发展过程中发挥着重要作用，有望成为重要的乳腺癌生物学行为及预后评估指标，her2与ki67、EGFR联合检测可有效提高对乳腺癌复发转移诊断的灵敏性和特异性。

Objective: To investigate the relationship between her2, ki67, EGFR expression and the biological behavior of breast cancer and its value in predicting recurrence and metastasis. Methods: 90 breast cancer patients admitted to our hospital from May 2019 to May 2021 were selected to analyze the relationship between her2, ki67, EGFR positive expression and age, histological staging, histological grading, clinical stage, lymph node metastasis, the presence of invasion of the vasculature, and the presence of invasion of nerves, comparing her2, ki67, and EGFR concentrations in patients with recurrent metastases versus those without recurrent metastases, Logistic regression models were developed by multifactorial analysis, and the diagnostic efficacy of the model was assessed using ROC curves. Results: Positive ki67 expression was associated with age, histological grade, and lymph node metastasis; the higher of the rate of ki67 positivity in patients aged ≥ 45 years, with higher histological grade, and with lymph node metastasis(P<0.05). her2 positive expression and EGFR positive expression were associated with histological grade and lymph node metastasis; the higher of the histological grade and the higher of the rate of her2 positive expression and EGFR positive expression in patients with lymph node metastasis(P<0.05). her2, ki67, and EGFR are not related to histological staging, clinical stage, or whether they invade the vasculature(P>0.05). Serum her2, ki67 and EGFR levels were higher in the recurrent metastasis group than in the non-recurrent metastasis group(P<0.05). Serum her2, ki67, and EGFR were all independent risk factors for breast cancer recurrence and metastasis(P<0.05). The sensitivity and specificity of serum her2, ki67 and EGFR alone and the combination of the three tests for the diagnosis of recurrent breast cancer metastasis were 83.30%, 75.00%, 53.30%, 95.00%, 66.70%, 75.00%, 86.70%, 83.30%, respectively. The diagnostic value of serum her2 alone for the detection of recurrent breast cancer metastasis was higher than the other two tests alone and the combination of the three tests was higher than the other single tests(P<0.05). Conclusion: her2 contributes to breast cancer lymph node metastasis, plays an important role in the development of breast cancer, and is expected to be an important indicator of biological behavior and prognosis assessment of breast cancer. her2 combined with ki67 and EGFR can effectively improve the sensitivity and specificity of the diagnosis of breast cancer recurrence and metastasis.

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