乳腺导管原位癌基底样亚型的鉴定。
Identification of a basal-like subtype of breast ductal carcinoma in situ.
作者信息
Livasy Chad A, Perou Charles M, Karaca Gamze, Cowan David W, Maia Diane, Jackson Susan, Tse Chiu-Kit, Nyante Sarah, Millikan Robert C
机构信息
Department of Pathology and Lab Medicine, University of North Carolina, Chapel Hill, NC 27599-7525, USA.
出版信息
Hum Pathol. 2007 Feb;38(2):197-204. doi: 10.1016/j.humpath.2006.08.017.
Microarray profiling of invasive breast carcinomas has identified subtypes including luminal A, luminal B, HER2-overexpressing, and basal-like. The poor-prognosis, basal-like tumors have been immunohistochemically characterized as estrogen receptor (ER)-negative, HER2/neu-negative, and cytokeratin 5/6-positive and/or epidermal growth factor receptor (EGFR)-positive. The aim of this study was to determine the prevalence of basal-like ductal carcinoma in situ in a population-based series of cases using immunohistochemical surrogates. A total of 245 pure ductal carcinoma in situ cases from a population-based, case-control study were evaluated for histologic characteristics and immunostained for ER, HER2/neu, EGFR, cytokeratin 5/6, p53, and Ki-67. The subtypes were defined as: luminal A (ER+, HER2-), luminal B (ER+, HER2+), HER2 positive (ER-, HER2+), and basal-like (ER-, HER2-, EGFR+, and/or cytokeratin 5/6+). The prevalence of breast cancer subtypes was basal-like (n = 19 [8%]); luminal A, n = 149 (61%); luminal B, n = 23 (9%); and HER2+/ER-, n = 38 (16%). Sixteen tumors (6%) were unclassified (negative for all 4 defining markers). The basal-like subtype was associated with unfavorable prognostic variables including high-grade nuclei (P < .0001), p53 overexpression (P < .0001), and elevated Ki-67 index (P < .0001). These studies demonstrate the presence of a basal-like in situ carcinoma, a potential precursor lesion to invasive basal-like carcinoma.
浸润性乳腺癌的基因芯片分析已确定了多种亚型,包括腔面A型、腔面B型、HER2过表达型和基底样型。预后较差的基底样肿瘤在免疫组织化学上的特征为雌激素受体(ER)阴性、HER2/neu阴性、细胞角蛋白5/6阳性和/或表皮生长因子受体(EGFR)阳性。本研究的目的是使用免疫组织化学替代指标,确定基于人群的一系列病例中基底样原位导管癌的患病率。对一项基于人群的病例对照研究中的245例纯原位导管癌病例进行了组织学特征评估,并对ER、HER2/neu、EGFR、细胞角蛋白5/6、p53和Ki-67进行了免疫染色。这些亚型被定义为:腔面A型(ER阳性、HER2阴性)、腔面B型(ER阳性、HER2阳性)、HER2阳性(ER阴性、HER2阳性)和基底样型(ER阴性、HER2阴性、EGFR阳性和/或细胞角蛋白5/6阳性)。乳腺癌亚型的患病率为:基底样型(n = 19 [8%]);腔面A型,n = 149(61%);腔面B型,n = 23(9%);HER2阳性/ER阴性,n = 38(16%)。16例肿瘤(6%)未分类(所有4种定义标志物均为阴性)。基底样亚型与不良预后变量相关,包括高级别核(P <.0001)、p53过表达(P <.0001)和Ki-67指数升高(P <.0001)。这些研究证明了基底样原位癌的存在,它是浸润性基底样癌的潜在前驱病变。