Eerola Hannaleena, Heikkilä Päivi, Tamminen Anitta, Aittomäki Kristiina, Blomqvist Carl, Nevanlinna Heli
Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.
Breast Cancer Res. 2005;7(1):R93-100. doi: 10.1186/bcr953. Epub 2004 Nov 19.
Histopathological features of BRCA1 and BRCA2 tumours have previously been characterised and compared with unselected breast tumours; however, familial non-BRCA1/2 tumours are less well known. The aim of this study was to characterise familial non-BRCA1/2 tumours and to evaluate routine immunohistochemical and pathological markers that could help us to further distinguish families carrying BRCA1/2 mutations from other breast cancer families.
Breast cancer tissue specimens (n = 262) from 25 BRCA1, 20 BRCA2 and 74 non-BRCA1/2 families were studied on a tumour tissue microarray. Immunohistochemical staining of oestrogen receptor (ER), progesterone receptor (PgR) and p53 as well as the histology and grade of these three groups were compared with each other and with the respective information on 862 unselected control patients from the archives of the Pathology Department of Helsinki University Central Hospital. Immunohistochemical staining of erbB2 was also performed among familial cases.
BRCA1-associated cancers were diagnosed younger and were more ER-negative and PgR-negative, p53-positive and of higher grade than the other tumours. However, in multivariate analysis the independent factors compared with non-BRCA1/2 tumours were age, grade and PgR negativity. BRCA2 cases did not have such distinctive features compared with non-BRCA1/2 tumours or with unselected control tumours. Familial cases without BRCA1/2 mutations had tumours of lower grade than the other groups.
BRCA1 families differed from mutation-negative families by age, grade and PgR status, whereas ER status was not an independent marker.
此前已对BRCA1和BRCA2肿瘤的组织病理学特征进行了描述,并与未筛选的乳腺肿瘤进行了比较;然而,家族性非BRCA1/2肿瘤却鲜为人知。本研究的目的是描述家族性非BRCA1/2肿瘤的特征,并评估常规免疫组化和病理标志物,以帮助我们进一步区分携带BRCA1/2突变的家族与其他乳腺癌家族。
在肿瘤组织芯片上研究了来自25个BRCA1家族(262例乳腺癌组织标本)、20个BRCA2家族(262例乳腺癌组织标本)和74个非BRCA1/2家族(262例乳腺癌组织标本)的乳腺癌组织标本。比较了雌激素受体(ER)、孕激素受体(PgR)和p53的免疫组化染色以及这三组的组织学和分级情况,并与赫尔辛基大学中心医院病理科档案中的862例未筛选对照患者的相应信息进行了比较。还对家族性病例进行了erbB2的免疫组化染色。
与其他肿瘤相比,BRCA1相关癌症的诊断年龄更小,ER阴性、PgR阴性、p53阳性且分级更高。然而,在多变量分析中,与非BRCA1/2肿瘤相比的独立因素是年龄、分级和PgR阴性。与非BRCA1/2肿瘤或未筛选的对照肿瘤相比,BRCA2病例没有此类独特特征。无BRCA1/2突变的家族性病例的肿瘤分级低于其他组。
BRCA1家族在年龄、分级和PgR状态方面与无突变家族不同,而ER状态不是一个独立的标志物。