title: Concentration of serum HER-2/neu as a prognostic factor in locally advanced breast cancer (LABC) and metastatic breast cancer (MBC).
abstract: OBJECTIVE
  to determine whether serum HER-2/neu level could be used as a prognostic factor in locally advanced breast cancer (LABC) and metastatic breast cancer (MBC).
  
  
  METHODS
  a prospective cohort study was done in LABC and MBC patients in dr. Sardjito Hospital Yogyakarta from April 2006 to March 2008. Serum concentration of HER-2/neu was measured by ELISA done before and after chemotherapy. HER-2/neu expression tissue examination was done by immunohistochemistry. The clinical responses on therapy, survival and progression were recorded.
  
  
  RESULTS
  twenty seven cases were obtained. Average concentration of serum HER-2/neu was 21.02 ± 7.1 ng/ml. The level of serum HER-2/neu in LABC was lower than MBC (17.21 ng/ml vs 28.64 ng/ml; p=0.32). Average concentration of serum HER-2/neu in partial responders was 13.20 ng/ml (95% Cl 0.142 - 26.25), stable responders was 19.42 ng/ml (95% Cl -0.255 - 39.09) and 29.35 ng/ml(95% Cl 1.95 - 56.74) in progressors (p=0.468). Patients with better clinical response had a lower average HER-2/neu serum level (16.12 ng/ml vs 29.35 ng/ml; p=0.247). HER-2/neu over expression was found in 40.7% of the tissues, 44% of LABC and 33.3% of MBC tissues (p=0.692). Negative HER-2/neu tissue protein expression had better clinical response (75% vs 45.5% p=0.224), and longer survival (p=0.08).
  
  
  CONCLUSIONS
  neither the expression of HER-2/neu in the tissue nor the level of serum HER-2/neu can be used as clinical prognosis factor on advanced stage breast cancer in our study population.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Gadjah Mada University - dr. Sardjito Hospital, Jl. Kesehatan 1, Sekip, Yogyakarta, Indonesia. dribnupwt@yahoo.com
authors.forename: Ibnu
authors.initials: I
authors.lastname: Purwanto
authors.forename: Johan
authors.initials: J
authors.lastname: Kurnianda
authors.forename: Kartika W T
authors.initials: KW
authors.lastname: Hariadi
authors.lastname: Harijadi
authors.forename: Teguh
authors.initials: T
authors.lastname: Aryandono
authors.forename: Kunta
authors.initials: K
authors.lastname: Setiaji
authors.forename: Mardiah S
authors.initials: MS
authors.lastname: Harianti
authors.forename: Sofia M
authors.initials: SM
authors.lastname: Haryana
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000556:secondary; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007214:Indonesia; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000556:secondary; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis / Q000097:blood*; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases