Eerola Hannaleena, Heinonen Mira, Heikkilä Päivi, Kilpivaara Outi, Tamminen Anitta, Aittomäki Kristiina, Blomqvist Carl, Ristimäki Ari, Nevanlinna Heli
Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu, 00029 HUS, Helsinki Finland.
Breast Cancer Res. 2008;10(1):R17. doi: 10.1186/bcr1863. Epub 2008 Feb 14.
Finding new immunohistochemical markers that are specific to hereditary breast cancer could help us to select candidates for BRCA1/BRCA2 mutation testing and to understand the biological pathways of tumour development.
Using breast cancer tumour microarrays, immunohistochemical expression of cytokeratin (CK)-5/6, CK-14 and CK-17 was evaluated in breast tumours from BRCA1 families (n = 46), BRCA2 families (n = 40), non-BRCA1/BRCA2 families (n = 358) and familial breast cancer patients with one first-degree relative affected by breast or ovarian cancer (n = 270), as well as from patients with sporadic breast cancer (n = 364). Staining for CK-5/6, CK-14 and CK-17 was compared between these groups and correlated with other clinical and histological factors.
CK-5/6, CK-14 and CK-17 were detected mostly among oestrogen receptor (ER)-negative, progesterone receptor (PR)-negative and high-grade tumours. We found the highest percentages of samples positive for these CKs among ER-negative/HER2-negative tumours. In univariate analysis, CK-14 was significantly associated with tumours from BRCA1 (39%; P < 0.0005), BRCA2 (27%; P = 0.011), and non-BRCA1/BRCA2 (21%; P < 0.005) families, as compared with sporadic tumours (10%). However, in multivariate analysis, CKs were not found to be independently associated with BRCA1 or BRCA2 mutation status, and the most effective predictors of BRCA1 mutations were age at onset, HER2 status, and either ER or PR status.
Although our study confirms that basal CKs can help to identify BRCA1 mutation carriers, this effect was weaker than previously suggested and CKs did not independently predict BRCA1 mutation either from sporadic or familial breast cancer cases. The most effective, independent predictors of BRCA1 mutations were age at onset, HER2 status, and either ER or PR status, as compared with sporadic or non-BRCA1/BRCA2 cancers.
寻找遗传性乳腺癌特有的新免疫组化标志物有助于我们筛选BRCA1/BRCA2突变检测的候选者,并了解肿瘤发生的生物学途径。
使用乳腺癌组织芯片,评估细胞角蛋白(CK)-5/6、CK-14和CK-17在来自BRCA1家系(n = 46)、BRCA2家系(n = 40)、非BRCA1/BRCA2家系(n = 358)以及有一位患乳腺癌或卵巢癌的一级亲属的家族性乳腺癌患者(n = 270),还有散发性乳腺癌患者(n = 364)的乳腺肿瘤中的免疫组化表达。比较这些组之间CK-5/6、CK-14和CK-17的染色情况,并与其他临床和组织学因素相关联。
CK-5/6、CK-14和CK-17大多在雌激素受体(ER)阴性、孕激素受体(PR)阴性和高级别肿瘤中检测到。我们在ER阴性/HER2阴性肿瘤中发现这些CK阳性样本的比例最高。在单变量分析中,与散发性肿瘤(10%)相比,CK-14与来自BRCA1家系(39%;P < 0.0005)、BRCA2家系(27%;P = 0.011)和非BRCA1/BRCA2家系(21%;P < 0.005)的肿瘤显著相关。然而,在多变量分析中,未发现CK与BRCA1或BRCA2突变状态独立相关,BRCA1突变的最有效预测因素是发病年龄、HER2状态以及ER或PR状态。
尽管我们的研究证实基底CK有助于识别BRCA1突变携带者,但这种作用比之前认为的要弱,并且CK不能独立预测散发性或家族性乳腺癌病例中的BRCA1突变。与散发性或非BRCA1/BRCA2癌症相比,BRCA1突变最有效、独立的预测因素是发病年龄、HER2状态以及ER或PR状态。