Balleine R L, Earl M J, Greenberg M L, Clarke C L
Westmead Institute for Cancer Research, University of Sydney, Westmead Hospital, NSW, Australia.
Br J Cancer. 1999 Mar;79(9-10):1564-71. doi: 10.1038/sj.bjc.6690249.
The relationship between expression of receptors for oestrogen and progesterone (ER and PR) and disease progression in breast cancer was investigated by comparing immunocytochemical determinations of ER and PR in fine needle aspirates from primary and secondary breast tumours. Rates of receptor expression were significantly higher in primary than in secondary lesions: for ER 63.3% (n = 689) compared with 45.3% (n = 223), and for PR 53.7% (n = 443) compared with 33.1% (n = 121). The effect of menopausal status was examined by subdividing the patient cohort into those over or under the age of 50 years. In both instances, ER expression in secondary tumours was relatively low; however, only postmenopausal patients had significantly lower rates of PR expression in secondary tumours. Consistent with this, an increase in the ER+PR- profile in secondary tumours compared with primary cases from postmenopausal patients was seen, and in a multivariate analysis, a specific absence of PR expression in secondary tumours was revealed. Comparison of ER and PR expression in simultaneously sampled primary tumours and lymph node metastases from the same patient showed that receptor expression was stable with progression to a metastatic site as results were concordant for ER in 92% (n = 88) and PR in 93.8% of cases (n = 65). These results suggest that absence of PR expression in primary breast cancer is associated with disease progression and may be a marker of an aggressive tumour phenotype.
通过比较原发性和继发性乳腺肿瘤细针穿刺物中雌激素和孕激素受体（ER和PR）的免疫细胞化学测定结果，研究了ER和PR表达与乳腺癌疾病进展之间的关系。原发性病变中受体表达率显著高于继发性病变：ER为63.3%（n = 689），而继发性病变中为45.3%（n = 223）；PR分别为53.7%（n = 443）和33.1%（n = 121）。通过将患者队列分为50岁以上或以下两组，研究了绝经状态的影响。在这两种情况下，继发性肿瘤中ER表达相对较低；然而，只有绝经后患者继发性肿瘤中PR表达率显著较低。与此一致的是，绝经后患者继发性肿瘤中ER+PR-模式相对于原发性病例有所增加，并且在多变量分析中，揭示了继发性肿瘤中PR表达的特异性缺失。对同一患者同时采集的原发性肿瘤和淋巴结转移灶中ER和PR表达的比较表明，随着进展至转移部位，受体表达是稳定的，因为92%（n = 88）的病例中ER结果一致，93.8%（n = 65）的病例中PR结果一致。这些结果表明，原发性乳腺癌中PR表达缺失与疾病进展相关，可能是侵袭性肿瘤表型的一个标志物。
