Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Am J Surg Pathol. 2009 Jul;33(7):1093-7. doi: 10.1097/PAS.0b013e31819c1c93.
BACKGROUND: Over 80% of breast cancers in women with germline BRCA1 mutations are estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2-negative ("triple negative") and most of these have a basal-like phenotype by expression profiling and immunophenotypic analysis. However, whether or not expression of biomarkers characteristic of basal-like breast cancers helps to define a subset of women with triple-negative breast cancers who are likely to harbor BRCA1 mutations is an unresolved issue. METHODS: We randomly identified 165 women from the Dana-Farber/Harvard Cancer Center SPORE annotated specimen bank with primary invasive, triple-negative breast cancers. Tissue microarrays were constructed by obtaining triplicate 0.6 mm cores from available paraffin blocks from 130 cases: only unstained slides were available for immunostaining from 35 cases. Slides cut from the tissue microarrays and the unstained slides were immunostained for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (to confirm triple-negative status) and for several markers that have been reported to be useful in defining the basal-like phenotype, including basal cytokeratins CK5/6, CK14, and CK17 and epidermal growth factor receptor (EGFR). Full sequencing analysis for BRCA1 germline mutations was performed on blood specimens from all cases. The final study population consisted of 144 cases in which (1) triple-negative status was confirmed; (2) there was sufficient material for analysis of basal cytokeratins and EGFR; and (3) germline BRCA1 mutation status was known. RESULTS: Among these triple-negative breast cancer cases, 97 (67%) expressed one or more basal cytokeratins and 102 (71%) showed EGFR expression. Basal cytokeratin expression was detected in 65% of the tumor from the 20 BRCA1 mutation carriers and in 68% of the cancers from women without mutations (P=NS). EGFR expression was identified in a similar proportion of tumors from women with and without BRCA1 mutations (75% vs. 72%, P=NS). CONCLUSIONS: Basal cytokeratin and EGFR expression are both highly prevalent among triple-negative breast cancers. The frequency of expression of basal cytokeratins and EGFR was similar in women with and without BRCA1 mutations. Therefore, although the expression of basal cytokeratins and/or EGFR can be used to identify triple-negative breast cancers that have a basal-like phenotype, expression of these markers alone is not sufficient to distinguish which women with triple-negative breast cancers are likely to harbor BRCA1 germline mutations.
背景:超过 80%的携带胚系 BRCA1 突变的女性乳腺癌为雌激素受体、孕激素受体和人表皮生长因子受体 2 阴性(“三阴性”),且大多数通过表达谱和免疫表型分析具有基底样表型。然而,是否存在基底样乳腺癌的特征性生物标志物表达有助于确定三阴性乳腺癌中可能携带 BRCA1 突变的亚组,这仍是一个悬而未决的问题。
方法:我们从丹娜-法伯/哈佛癌症中心 SPORE 注释标本库中随机选择了 165 名患有原发性浸润性三阴性乳腺癌的女性。通过从 130 例中获得 3 个重复 0.6 毫米的核心来构建组织微阵列:仅 35 例的未染色幻灯片可用于免疫染色。从组织微阵列和未染色的载玻片上切下的载玻片被免疫染色以确认雌激素受体、孕激素受体和人表皮生长因子受体 2(以确认三阴性状态),并被用于定义基底样表型的几种标记物,包括基底细胞角蛋白 CK5/6、CK14 和 CK17 和表皮生长因子受体(EGFR)。对所有病例的血液标本进行了 BRCA1 种系突变的全序列分析。最终的研究人群包括 144 例符合以下条件的病例:(1) 确认三阴性状态;(2) 有足够的分析基底细胞角蛋白和 EGFR 的材料;(3) 种系 BRCA1 突变状态已知。
结果:在这些三阴性乳腺癌病例中,97 例(67%)表达一种或多种基底细胞角蛋白,102 例(71%)显示 EGFR 表达。在 20 名 BRCA1 突变携带者的肿瘤中检测到 65%的基底细胞角蛋白表达,在无突变的女性肿瘤中检测到 68%(P=NS)。在有和无 BRCA1 突变的女性肿瘤中,EGFR 表达的比例相似(75%与 72%,P=NS)。
结论:基底细胞角蛋白和 EGFR 的表达在三阴性乳腺癌中均高度普遍。在有和无 BRCA1 突变的女性中,基底细胞角蛋白和 EGFR 的表达频率相似。因此,尽管基底细胞角蛋白和/或 EGFR 的表达可用于识别具有基底样表型的三阴性乳腺癌,但仅表达这些标志物不足以区分哪些三阴性乳腺癌患者可能携带 BRCA1 种系突变。
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