Gonzalez-Angulo Ana Maria, Sahin Aysegul, Krishnamurthy Savitry, Yang Ying, Kau Shu-Wan, Hortobagyi Gabriel N, Cristofanilli Massimo
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Clin Breast Cancer. 2006 Dec;7(5):396-400. doi: 10.3816/CBC.2006.n.056.
The objective of this study was to compare the differential expression of established histopathologic and biologic markers of proliferation, apoptosis, and angiogenesis in invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) in a group of axillary node-negative breast cancers.
Two hundred twenty patients with axillary node-negative ILC and IDC who underwent surgery at the University of Texas M. D. Anderson Cancer Center between 1978 and 1995 had tissue available for analysis. Of these, 206 (94%) had IDC and 14 (6%) had ILC. Estrogen receptors, progesterone receptors, tumor and stromal expression of vascular endothelial growth factor receptor 2, CD44, laminin-5, E-cadherin, and topoisomerase-2 were evaluated by immunohistochemical analysis. HER2/neu and alpha6beta4 integrin were evaluated by in situ hybridization. The Fisher exact test was used to calculate significant differences between ILC and IDC. Median age was 59 years.
Invasive lobular carcinoma was more likely to occur in patients aged > 50 years. Invasive lobular carcinoma tended to be > 2 cm (50% vs. 39%), have a nuclear grade of 1/2 (100% vs. 72%), be estrogen receptor positive (93% vs. 70%), HER2/neu negative (92% vs. 68%), have high CD44 expression (31% vs. 16%), low stromal vascular endothelial growth factor receptor 2 expression (36% vs. 47%), no E-cadherin expression (0 vs. 90%), and low laminin-5 expression (15% vs. 25%), compared with IDC.
Invasive lobular carcinoma and IDC might be distinct histologic types of breast cancer with different expression of biologic markers. These differences, not all being statistically significant in this small study, might generate hypotheses to develop tailored options for future systemic therapy.
本研究的目的是比较一组腋窝淋巴结阴性乳腺癌中浸润性小叶癌（ILC）和浸润性导管癌（IDC）中已确立的增殖、凋亡和血管生成的组织病理学及生物学标志物的差异表达。
1978年至1995年间在德克萨斯大学MD安德森癌症中心接受手术的220例腋窝淋巴结阴性的ILC和IDC患者有可供分析的组织。其中，206例（94%）为IDC，14例（6%）为ILC。通过免疫组织化学分析评估雌激素受体、孕激素受体、血管内皮生长因子受体2、CD44、层粘连蛋白-5、E-钙黏蛋白和拓扑异构酶-2在肿瘤及间质中的表达。通过原位杂交评估HER2/neu和α6β4整合素。采用Fisher精确检验计算ILC和IDC之间的显著差异。中位年龄为59岁。
浸润性小叶癌更易发生于年龄>50岁的患者。与IDC相比，浸润性小叶癌更倾向于直径>2 cm（50%对39%），核分级为1/2级（100%对72%），雌激素受体阳性（93%对70%）, HER2/neu阴性（92%对68%），CD44高表达（31%对16%），间质血管内皮生长因子受体2低表达（36%对47%），无E-钙黏蛋白表达（0对90%），层粘连蛋白-5低表达（15%对25%）。
浸润性小叶癌和IDC可能是具有不同生物学标志物表达的不同组织学类型的乳腺癌。这些差异在本小型研究中并非全部具有统计学意义，可能会为未来的全身治疗开发量身定制方案提供假设。
