Abstract：
OBJECTIVE: The aim of this study is to evaluate the clinicopathological features and prognostic significance of HER2 low, fibrotic focus (FF), and tumor-infiltrating lymphocytes (TILs) in patients with HER2-negative breast cancer.
METHODS: We retrospectively reviewed the data of 293 patients with HER2-negative, stage I-II, invasive breast cancer of non-specific types. The HER2-negative cases were classified into HER2 low and HER2 0. Digital analysis of hematoxylin-eosin stained whole slide images was used to evaluate the FF expression. TILs were also evaluated using the Whole Slide Image. Furthermore, the association between HER2 low, FF, and TILs as well as their prognostic significance were analyzed.
RESULTS: The study cohort included 178 cases (60.8%) with HER2 low and 115 cases (39.2%) with HER2 0. Older age, lower Nottingham histological grade (NHG), estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, and hormone receptor (HR) positivity were all associated with HER2 low. FF was correlated with older age, intermediate and low NHG, vascular invasion, HR positivity, HER2 low status, high Ki67 expression, and low TILs. Univariate survival analysis showed that FF was significantly associated with shorter progression-free survival (PFS). Stratified analysis indicated that in the HR-negative and HR-positive groups, HER2 status and TILs did not affect PFS. DFS was longer in patients without FF compared to those with FF in the HR-positive (hazard ratio [HR] = 0.313) and HER2 low (HR = 0.272) groups. DFS was also significantly longer in patients without FF compared to those with FF in the HR-negative (HR = 0.069) and HER2 0 groups (HR = 0.129).
CONCLUSIONS: The results indicated that the HER2 low status and the TILs expression did not impact prognosis. However, patients with FF exhibited distinct biological characteristics and prognostic significance, particularly in the HR-negative and HER2 0 groups. This provides a rationale for accurate diagnosis and treatment of HER2-negative breast cancer.
METHODS: We retrospectively reviewed the data of 293 patients with HER2-negative, stage I-II, invasive breast cancer of non-specific types. The HER2-negative cases were classified into HER2 low and HER2 0. Digital analysis of hematoxylin-eosin stained whole slide images was used to evaluate the FF expression. TILs were also evaluated using the Whole Slide Image. Furthermore, the association between HER2 low, FF, and TILs as well as their prognostic significance were analyzed.
RESULTS: The study cohort included 178 cases (60.8%) with HER2 low and 115 cases (39.2%) with HER2 0. Older age, lower Nottingham histological grade (NHG), estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, and hormone receptor (HR) positivity were all associated with HER2 low. FF was correlated with older age, intermediate and low NHG, vascular invasion, HR positivity, HER2 low status, high Ki67 expression, and low TILs. Univariate survival analysis showed that FF was significantly associated with shorter progression-free survival (PFS). Stratified analysis indicated that in the HR-negative and HR-positive groups, HER2 status and TILs did not affect PFS. DFS was longer in patients without FF compared to those with FF in the HR-positive (hazard ratio [HR] = 0.313) and HER2 low (HR = 0.272) groups. DFS was also significantly longer in patients without FF compared to those with FF in the HR-negative (HR = 0.069) and HER2 0 groups (HR = 0.129).
CONCLUSIONS: The results indicated that the HER2 low status and the TILs expression did not impact prognosis. However, patients with FF exhibited distinct biological characteristics and prognostic significance, particularly in the HR-negative and HER2 0 groups. This provides a rationale for accurate diagnosis and treatment of HER2-negative breast cancer.
摘要：
目的：本研究的目的是评估低HER2的临床病理特征和预后意义。纤维化病灶(FF),和HER2阴性乳腺癌患者的肿瘤浸润淋巴细胞（TIL）。
方法：我们回顾性回顾了293例HER2阴性患者的数据，I-II阶段,非特异性类型的浸润性乳腺癌。HER2阴性病例分为低HER2和0HER2。使用苏木精-伊红染色的整个载玻片图像的数字分析来评估FF表达。还使用全幻灯片图像评价TIL。此外，HER2低，FF,和TILs及其预后意义进行了分析。
结果：研究队列包括178例（60.8%）低HER2患者和115例（39.2%）0HER2患者。年纪大了,较低的诺丁汉组织学等级（NHG），雌激素受体（ER）阳性，孕激素受体（PR）阳性，激素受体（HR）阳性均与HER2低相关。FF与年龄相关，中等和低NHG，血管浸润,人力资源积极性，HER2低状态，Ki67高表达，低TIL。单因素生存分析显示，FF与较短的无进展生存期（PFS）显著相关。分层分析表明，在HR阴性和HR阳性组中，HER2状态和TILs不影响PFS。与HR阳性（风险比[HR]=0.313）和HER2低（HR=0.272）组的FF患者相比，无FF患者的DFS更长。与HR阴性（HR=0.069）和HER20组（HR=0.129）的FF患者相比，无FF患者的DFS也明显更长。
结论：结果表明HER2低状态和TILs表达不影响预后。然而,FF患者表现出明显的生物学特征和预后意义，特别是在HR阴性和HER20组中。这为HER2阴性乳腺癌的准确诊断和治疗提供了理论基础。
方法：我们回顾性回顾了293例HER2阴性患者的数据，I-II阶段,非特异性类型的浸润性乳腺癌。HER2阴性病例分为低HER2和0HER2。使用苏木精-伊红染色的整个载玻片图像的数字分析来评估FF表达。还使用全幻灯片图像评价TIL。此外，HER2低，FF,和TILs及其预后意义进行了分析。
结果：研究队列包括178例（60.8%）低HER2患者和115例（39.2%）0HER2患者。年纪大了,较低的诺丁汉组织学等级（NHG），雌激素受体（ER）阳性，孕激素受体（PR）阳性，激素受体（HR）阳性均与HER2低相关。FF与年龄相关，中等和低NHG，血管浸润,人力资源积极性，HER2低状态，Ki67高表达，低TIL。单因素生存分析显示，FF与较短的无进展生存期（PFS）显著相关。分层分析表明，在HR阴性和HR阳性组中，HER2状态和TILs不影响PFS。与HR阳性（风险比[HR]=0.313）和HER2低（HR=0.272）组的FF患者相比，无FF患者的DFS更长。与HR阴性（HR=0.069）和HER20组（HR=0.129）的FF患者相比，无FF患者的DFS也明显更长。
结论：结果表明HER2低状态和TILs表达不影响预后。然而,FF患者表现出明显的生物学特征和预后意义，特别是在HR阴性和HER20组中。这为HER2阴性乳腺癌的准确诊断和治疗提供了理论基础。
