乳腺癌新辅助治疗前后HER-2变化和临床意义研究

Objective To explore the expression levels and changes of human epidermal growth factor receptor 2(HER-2) before and after neoadjuvant therapy for breast cancer, as well as their clinical significance. Methods Patients who were admitted to the breast surgery department of our hospital from January 2024 to January 2026 and were initially diagnosed as HER-2 positive and received neoadjuvant therapy were selected. According to the inclusion and exclusion criteria, a total of 120 patients were screened. The same neoadjuvant treatment method was used for treatment. The expression levels of HER-2 were determined by immunohistochemistry and fluorescence in situ hybridization, and the pathological complete response rate was used as an indicator to observe the trend of HER-2 changes in patients with different levels after treatment. Results A total of 85 patients were classified into the HER-2 IHC3+ group, with an average age of(53.29±9.83) years, and 35 patients were in the HER-2 IHC2+/FISH+ group, with an average age of(53.88±10.16) years. There were no differences in menstrual status, family history of tumors, distant metastasis of tumors, and tumor histological type between the two groups. However, there were significant differences in the size of the primary tumor and the lymph node status. The change rate of HER-2 levels before and after neoadjuvant therapy reached 11.67%, and the transformation rate was higher in the HER-2 IHC3+ group. In terms of pathological remission, 66 out of 120 patients achieved pathological complete remission, and the complete remission rate in the HER-2 IHC3+ group was significantly higher than that in the HER-2 IHC2+/FISH+ group, with a statistically significant difference(P<0.05). Conclusion In HER-2 positive breast cancer, the inconsistency in HER-2 expression levels may be associated with different pathological conditions. The expression level of HER-2 also varies in terms of sensitivity to neoadjuvant therapy. HER-2 IHC3+ has a higher sensitivity.