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High serum HER2 extracellular domain levels: correlation with a worse disease-free survival and overall survival in primary operable breast cancer patients

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Abstract

Purpose

High serum human epidermal growth factors receptor-2 (HER2) extracellular domain (ECD) has been identified as an independent prognostic indicator of poor prognosis in metastatic breast cancer. However, its prognostic value in primary operable breast cancer was still controversial. We aim to investigate the correlation between serum HER2 ECD levels and tissue HER2 status, the association between serum HER2 ECD levels and clinicopathological characteristics, and their impacts on disease-free survival (DFS) and overall survival (OS) in primary operable breast cancer.

Methods

Two hundred and fifty-two primary operable breast cancer patients pretreated from 2002 to 2009 in Sun Yat-Sen University Cancer Center were enrolled in this study. Serum HER2 ECD was measured by chemiluminescent assay, and tissue HER2 status was accessed by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) assay.

Results

There was a significant correlation between serum HER2 ECD levels and HER2 tissue status (P < 0.001, R = 0.36). High serum HER2 ECD levels (≥15 ng/mL) were significantly associated with age (≥35 years) (P = 0.028), postmenopausal status (P < 0.001), stage III (P < 0.001), tumor size (≥2 cm) (P < 0.001), lymph node involvement (P < 0.001), negative estrogen receptor (P = 0.005), and progesterone receptor status (P = 0.001). Multivariate analysis showed that high serum HER2 ECD level was an independent prognostic factor of worse DFS (P = 0.014) and OS (P = 0.014) in primary operable breast cancer patients.

Conclusion

Serum HER2 ECD level can reflect tissue HER2 status and can be an independent prognostic indicator for primary operable breast cancer patients.

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Acknowledgments

We thank all the patients who participate in this study. Grant support is given by Key Program of National Natural Science Foundation of China (31030061); Natural Science Foundation of Guangdong Province, China (9151008901000124); Science and Technology Planning Project of Guangzhou, China (10C32060205).

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Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China

    Yanan Kong, Shuqin Dai, Xinhua Xie, Xiangsheng Xiao, Ning Lv, Jiaoli Guo, Laisheng Li, Weihua Jia, Yin Zhang, Wanli Liu, Weidong Wei & Xiaoming Xie

  2. Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China

    Yanan Kong, Xinhua Xie, Xiangsheng Xiao, Ning Lv, Jiaoli Guo, Laisheng Li, Weidong Wei & Xiaoming Xie

  3. Department of Medical Examination, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China

    Shuqin Dai & Wanli Liu

  4. Department of Specimen and Resource, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People’s Republic of China

    Weihua Jia & Yin Zhang

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  1. Yanan Kong
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  2. Shuqin Dai
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  9. Yin Zhang
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  11. Weidong Wei
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  12. Xiaoming Xie
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Correspondence to Weidong Wei or Xiaoming Xie.

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Yanan Kong and Shuqin Dai contributed equally to this article.

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Kong, Y., Dai, S., Xie, X. et al. High serum HER2 extracellular domain levels: correlation with a worse disease-free survival and overall survival in primary operable breast cancer patients. J Cancer Res Clin Oncol 138, 275–284 (2012). https://doi.org/10.1007/s00432-011-1095-9

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  • DOI: https://doi.org/10.1007/s00432-011-1095-9

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