Botti C, Pescatore B, Mottolese M, Sciarretta F, Greco C, Di Filippo F, Gandolfo G M, Cavaliere F, Bovani R, Varanese A, Cianciulli A M
Department of Surgical Oncology, Regina Elena Cancer Institute, Rome, Italy.
J Am Coll Surg. 2000 May;190(5):530-9. doi: 10.1016/s1072-7515(00)00252-0.
Characterization of the biopathologic events underlying the early steps of breast carcinogenesis may have a dramatic impact on reducing breast cancer mortality. Genes involved in breast tumorigenesis are localized on chromosomes 1 and 17, and numeric aberrations of these chromosomes have been correlated with breast cancer tumorigenesis and progression. According to the field cancerization hypothesis, specific chromosome aberrations may be present in breast cancer and in normal-appearing adjacent tissue. The latter changes reflect the genomic damage that follows longterm carcinogenic exposure and precede the morphologically detectable neoplastic transformation. We hypothesize that detection of these aberrations in benign breast epithelium may provide a tool for molecular risk assessment.
Using fluorescence in situ hybridization with centromere-specific probes, we determined the status of chromosomes 1 and 17 in fresh imprints of 28 samples of primary tumors and 54 samples of their surrounding uninvolved parenchyma taken from patients undergoing operations for breast carcinoma. Ten contralateral breast biopsy specimens collected from patients with previous breast carcinoma were also evaluated as a surrogate of a high-risk group to rule out the hypothesis that chromosomal aneusomy in tumor-adjacent tissue could be related to a paracrine effect of the primary tumor. Ten samples of benign breast tissue taken from patients at low risk were used as controls to define tolerance limits for aneusomy definition.
Using threshold values of 40% of signal loss and 13% of signal gain to define chromosome aneusomy (ie, mean + 3 SDs of the control group signals), we found the following: 1) almost all primary breast tumors were aneusomic for chromosomes 1 and 17; 2) primary breast tumor and adjacent uninvolved parenchyma shared the same pattern of chromosomes 1 and 17 aneusomy in 66.7% of patients; and 3) chromosomes 1 and 17 aneusomies in contralateral benign breast samples from high-risk patients were not different from those in primary breast tumor or adjacent tissue samples.
These results suggest that chromosomes 1 and 17 aneusomy may represent an intermediate biomarker of breast tumorigenesis potentially useful to detect patients at high risk of breast carcinoma who may benefit from preventive interventions.
表征乳腺癌发生早期阶段潜在的生物病理事件可能对降低乳腺癌死亡率产生重大影响。参与乳腺肿瘤发生的基因定位于1号和17号染色体,这些染色体的数目畸变与乳腺癌的发生和进展相关。根据场癌化假说,特定的染色体畸变可能存在于乳腺癌组织以及外观正常的邻近组织中。后者的变化反映了长期致癌暴露后、形态学上可检测到的肿瘤转化之前的基因组损伤。我们推测,在良性乳腺上皮中检测到这些畸变可能为分子风险评估提供一种工具。
我们使用着丝粒特异性探针进行荧光原位杂交,确定了28例原发性肿瘤样本及其周围未受累实质组织的54个样本(取自接受乳腺癌手术的患者)新鲜印片中1号和17号染色体的状态。从既往有乳腺癌病史的患者中收集的10例对侧乳腺活检标本也作为高危组的替代样本进行评估,以排除肿瘤邻近组织中的染色体非整倍体可能与原发性肿瘤的旁分泌效应相关这一假说。从低风险患者中获取的10例良性乳腺组织样本用作对照,以确定非整倍体定义的耐受限度。
使用信号缺失40%和信号增加13%的阈值来定义染色体非整倍体(即对照组信号的均值 + 3个标准差),我们发现如下情况:1)几乎所有原发性乳腺肿瘤的1号和17号染色体均为非整倍体;2)在66.7%的患者中,原发性乳腺肿瘤及其周围未受累实质组织的1号和17号染色体非整倍体模式相同;3)高危患者对侧良性乳腺样本中的1号和17号染色体非整倍体与原发性乳腺肿瘤或邻近组织样本中的无差异。
这些结果表明,1号和17号染色体非整倍体可能代表乳腺肿瘤发生的一种中间生物标志物,可能有助于检测出可能从预防性干预中获益的高危乳腺癌患者。