Kurebayashi Junichi, Moriya Takuya, Ishida Takanori, Hirakawa Hisashi, Kurosumi Masafumi, Akiyama Futoshi, Kinoshita Takayuki, Takei Hiroyuki, Takahashi Kaoru, Ikeda Masahiko, Nakashima Kazutaka
Department of Breast and Thyroid Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan.
Breast. 2007 Dec;16 Suppl 2:S72-7. doi: 10.1016/j.breast.2007.07.017. Epub 2007 Aug 21.
A recent report indicated that a high prevalence of basal-like breast tumors (estrogen receptor [ER]-negative, progesterone receptor [PR]-negative, human epidermal growth factor receptor [HER] 2-negative, and cytokeratin 5/6-positive and/or HER1-positive) could contribute to a poor prognosis in African American women with breast cancer. It has been reported that Japanese women with breast cancer have a significantly better survival rate than other races in the USA. These findings suggest that breast cancers in Japanese women have favorable biological characteristics. To clarify this hypothesis, we conducted a cohort study to investigate the prevalence of intrinsic subtypes and prognosis for each subtype in 793 Japanese patients. This study revealed a very low prevalence (only 8%) of basal-like breast tumors with aggressive biological characteristics in Japanese patients. Survival analysis showed a significantly poorer prognosis in patients with basal-like tumors than in those with luminal A tumors (ER- and/or PR-positive, and HER2-negative) with favorable biological characteristics. These findings support the hypothesis that breast cancers in Japanese women have more favorable biological characteristics and a better prognosis than those in other races. In conclusion, the prevalence of basal-like breast tumors could influence the prognosis of breast cancer patients of different races. The prevalence of intrinsic subtypes should be taken into account when analyzing survival data in a multi-racial/international clinical study.
最近的一份报告指出，基底样乳腺癌（雌激素受体[ER]阴性、孕激素受体[PR]阴性、人表皮生长因子受体[HER]2阴性，细胞角蛋白5/6阳性和/或HER1阳性）的高患病率可能导致非裔美国乳腺癌女性预后不良。据报道，日本乳腺癌女性的生存率明显高于美国其他种族。这些发现表明，日本女性的乳腺癌具有良好的生物学特征。为了阐明这一假设，我们进行了一项队列研究，以调查793名日本患者中内在亚型的患病率以及每种亚型的预后情况。这项研究显示，日本患者中具有侵袭性生物学特征的基底样乳腺癌患病率非常低（仅8%）。生存分析表明，基底样肿瘤患者的预后明显比具有良好生物学特征的腔面A型肿瘤（ER和/或PR阳性，HER2阴性）患者差。这些发现支持了这一假设，即日本女性的乳腺癌比其他种族的乳腺癌具有更良好的生物学特征和更好的预后。总之，基底样乳腺癌的患病率可能影响不同种族乳腺癌患者的预后。在多种族/国际临床研究中分析生存数据时，应考虑内在亚型的患病率。
