子宫内膜癌患者人表皮生长因子受体2表达及其相关因素

张诗韵; 蒋诗阳; 史庭燕

doi:10.12025/j.issn.1008-6358.2025.20250466

子宫内膜癌患者人表皮生长因子受体2表达及其相关因素

Human epidermal growth factor receptor 2 expression and associated factors in endometrial carcinoma

摘要

摘要:
目的探讨子宫内膜癌（endometrial carcinoma，EC）患者的人表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）表达及相关临床、病理及影像特征。
方法回顾性纳入2022年1月至2024年12月复旦大学附属中山医院收治的214例初治EC患者，通过免疫组织化学（immunohistochemistry，IHC）染色评估HER2表达，分析其与临床参数、病理特征以及影像学指标的关系。
结果 EC患者HER2表达（IHC评分1＋/2＋/3＋）率为37.4%（80/214）。HER2表达与高龄、国际妇产科联盟（International Federation of Gynecology and Obstetrics，FIGO）分期进展、侵袭性组织学类型、分子分型P53abn以及术前盆腔磁共振成像（magnetic resonance imaging，MRI）病灶的低表观弥散系数（apparent diffusion coefficient，ADC）显著相关。多因素分析表明，侵袭性组织学类型（P＝0.002）以及术前盆腔MRI病灶的低ADC值（P＝0.047）是EC组织HER2表达的独立相关因素。
结论 EC术前MRI病灶ADC值可作为无创预测HER2表达状态的潜在指标，组织学类型是精准导向HER2检测的重要依据。

Abstract:
Objective To explore the expression of human epidermal growth factor receptor 2 (HER2) and its associations with clinical, pathological, and imaging characteristics in endometrial carcinoma (EC) patients.
Methods A retrospective analysis was conducted on 214 patients with newly diagnosed EC treated at Zhongshan Hospital, Fudan University, from January 2022 to December 2024. HER2 expression was assessed using immunohistochemistry (IHC) staining, and its associations with clinical characteristics, histopathological and imaging features were analyzed.
Results The HER2 expression rate (IHC score of 1＋/2＋/3＋) in EC was 37.4% (80/214). HER2 expression was significantly associated with older age, advanced International Federation of Gynecology and Obstetrics (FIGO) stage, aggressive histological types, P53abn and low apparent diffusion coefficient (ADC) of preoperative pelvic magnetic resonance imaging (MRI). Multivariate analysis indicated that aggressive histological types (P＝0.002) and low ADC of preoperative pelvic MRI (P＝0.047) were independent factors associated with HER2 expression.
Conclusions ADC of EC lesions may serve as a non-invasive predictive marker for HER2 expression, while histological type provides a critical basis for precisely guiding HER2 testing.

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