Choi Doo Ho, Kim Sung, Rimm David L, Carter Darryl, Haffty Bruce G
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Cancer J. 2005 Sep-Oct;11(5):404-11. doi: 10.1097/00130404-200509000-00008.
Young women with breast cancer have a poor prognosis, and the role of biologic markers in young women is not well defined. We investigated the association of estrogen receptor, progesterone receptor, Bcl-2, HER-2/neu, p53, and Ki-67 with clinicopathologic features and outcome in young women with breast cancer.
A cohort of 103 patients with early-onset breast cancer treated with conservative surgery and radiotherapy were entered in this study. Age range was 25-45 years, and median follow-up was 8.7 years. Each of the paraffin-embedded specimens was immunologically stained for six biomarkers expression by a recently developed tissue microarray method.
The 10-year overall breast relapse-free and distant relapse-free survival rates were 82.7%, 84.6.4%, and 66.7%, respectively, with 14 local relapses and 26 distant metastases among the 103 patients evaluated. Positive expression of estrogen receptor, progesterone receptor, bcl-2, HER-2/neu, p53, and Ki-67 were 42.7%, 48.5%, 35.6%, 28.0%, 36.9%, and 39.7%, respectively. Tumor stage and nodal status were significantly associated with overall survival and distant metastasis-free rate in univariate and multivariate analysis. Progesterone receptor negativity and Ki-67 positivity were associated with distant metastasis. There was no statistically significant correlation between the six biomarkers and local relapse.
Progesterone receptor, Ki-67, tumor stage, and nodal status were prognostic factors for distant failure in early-stage breast cancer in young patients. Further studies are needed to find other biologic markers associated with local failure in this group of patients.
年轻乳腺癌女性预后较差，生物标志物在年轻女性中的作用尚不明确。我们研究了雌激素受体、孕激素受体、Bcl-2、HER-2/neu、p53和Ki-67与年轻乳腺癌女性临床病理特征及预后的相关性。
本研究纳入了103例接受保乳手术和放疗的早发性乳腺癌患者。年龄范围为25 - 45岁，中位随访时间为8.7年。通过最近开发的组织微阵列方法对每个石蜡包埋标本进行六种生物标志物表达的免疫染色。
在评估的103例患者中，10年总体无乳腺复发和无远处复发生存率分别为82.7%、84.6%和66.7%，有14例局部复发和26例远处转移。雌激素受体、孕激素受体、bcl-2、HER-2/neu、p53和Ki-67的阳性表达分别为42.7%、48.5%、35.6%、28.0%、36.9%和39.7%。在单因素和多因素分析中，肿瘤分期和淋巴结状态与总生存率和无远处转移率显著相关。孕激素受体阴性和Ki-67阳性与远处转移相关。六种生物标志物与局部复发之间无统计学显著相关性。
孕激素受体、Ki-67、肿瘤分期和淋巴结状态是年轻患者早期乳腺癌远处复发的预后因素。需要进一步研究以找到与该组患者局部复发相关的其他生物标志物。
