Bird P A, Hill A G, Houssami N
Africa Inland Church (AIC) Kijabe Hospital, Kijabe, Kenya.
Ann Surg Oncol. 2008 Jul;15(7):1983-8. doi: 10.1245/s10434-008-9900-7. Epub 2008 Apr 12.
Few studies have examined breast cancer hormone receptor expression in Africans. We report on the hormone receptor profile of breast cancer in East Africans in the largest prospective study for this region.
Consecutive breast cancer presentations to a hospital in Kijabe (2001-2007) were included. Demographic, clinical, and test data were collected. ER/PR and Her2 testing was based on immunohistochemistry (IHC).
There were 129 subjects (median 47 years), most had invasive ductal cancer and locally advanced disease and/or metastases. ER/PR testing was done in 120: 24% had ER-positive tumours, 34% were ER- and/or PR-positive, 10% were ER-negative but PR-positive tumours, and 66% were negative for ER and PR. ER/PR positivity was not associated with stage (P = 0.28) and was not related to age, parity, menopausal status, or node metastases. Increasing tumour grade was associated with PR expression (P = 0.02) with decreasing frequency of PR positive tumours as histological grade increased; there was weak evidence of an association between grade and ER expression (P = 0.06). Of cases tested, 26.5% overexpressed Her2.
Breast cancer in Kijabe is an advanced-stage disease, comprised mainly of poorly differentiated cancers that are less likely to be hormone sensitive (across all stages of disease). ER/PR testing of all those affected by breast cancer should be supported as a global priority in cancer control. International and inter-African research collaborations are needed to allow genetic detailing of tumours in indigenous Africans to assess possible racial heterogeneity in the biology of breast cancer.
很少有研究对非洲人的乳腺癌激素受体表达情况进行过调查。我们在该地区规模最大的前瞻性研究中报告了东非乳腺癌的激素受体特征。
纳入了2001年至2007年期间在基贾贝一家医院连续就诊的乳腺癌患者。收集了人口统计学、临床和检测数据。雌激素受体（ER）/孕激素受体（PR）和人表皮生长因子受体2（Her2）检测基于免疫组织化学（IHC）。
共有129名受试者（中位年龄47岁），大多数患有浸润性导管癌以及局部晚期疾病和/或转移。对120名患者进行了ER/PR检测：24%的患者肿瘤为ER阳性，34%为ER和/或PR阳性，10%为ER阴性但PR阳性肿瘤，66%的患者ER和PR均为阴性。ER/PR阳性与分期无关（P = 0.28），也与年龄、产次、绝经状态或淋巴结转移无关。肿瘤分级增加与PR表达相关（P = 0.02），随着组织学分级增加，PR阳性肿瘤的频率降低；有微弱证据表明分级与ER表达之间存在关联（P = 0.06）。在检测的病例中，26.5%的患者Her2过表达。
基贾贝的乳腺癌是一种晚期疾病，主要由低分化癌组成，这些癌症对激素不太敏感（在疾病的所有阶段）。作为癌症控制的全球优先事项，应支持对所有乳腺癌患者进行ER/PR检测。需要开展国际和非洲内部的研究合作，以便对非洲本土人群的肿瘤进行基因详细分析，以评估乳腺癌生物学中可能存在的种族异质性。
