Ma Huiyan, Wang Yaping, Sullivan-Halley Jane, Weiss Linda, Burkman Ronald T, Simon Michael S, Malone Kathleen E, Strom Brian L, Ursin Giske, Marchbanks Polly A, McDonald Jill A, Spirtas Robert, Press Michael F, Bernstein Leslie
Division of Cancer Etiology, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA 91010, USA.
Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2214-20. doi: 10.1158/1055-9965.EPI-09-0301.
We investigated the extent to which estrogen receptor (ER) and progesterone receptor (PR) status results from a centralized pathology laboratory agree with ER and PR results from community pathology laboratories reported to two Surveillance, Epidemiology and End Results (SEER) registries (Los Angeles County and Detroit) and whether statistical estimates for the association between reproductive factors and breast cancer receptor subtypes differ by the source of data. The agreement between the centralized laboratory and SEER registry classifications was substantial for ER (kappa = 0.70) and nearly so for PR status (kappa = 0.60). Among the four subtypes defined by joint ER and PR status, the agreement between the two sources was substantial for the two major breast cancer subtypes (ER-/PR-, kappa = 0.69; ER+/PR+, kappa = 0.62) and poor for the two rarer subtypes (ER+/PR-, kappa = 0.30; ER-/PR+, kappa = 0.05). Estimates for the association between reproductive factors (number of full-term pregnancies, age at first full-term pregnancy, and duration of breastfeeding) and the two major subtypes (ER+/PR+ and ER-/PR-) differed minimally between the two sources of data. For example, parous women with at least four full-term pregnancies had 40% lower risk for ER+/PR+ breast cancer than women who had never been pregnant [centralized laboratory, odds ratio, 0.60 (95% confidence interval, 0.39-0.92); SEER, odds ratio, 0.57 (95% confidence interval, 0.38-0.85)]; no association was observed for ER-/PR- breast cancer (both P(trend) > 0.30). Our results suggest that conclusions based on SEER registry data are reasonably reliable for ER+/PR+ and ER-/PR- subtypes.
我们调查了中央病理实验室的雌激素受体(ER)和孕激素受体(PR)状态结果与向两个监测、流行病学和最终结果(SEER)登记处(洛杉矶县和底特律)报告的社区病理实验室的ER和PR结果的一致程度,以及生殖因素与乳腺癌受体亚型之间关联的统计估计是否因数据来源而异。中央实验室与SEER登记处分类之间对于ER的一致性很强(kappa = 0.70),对于PR状态几乎也是如此(kappa = 0.60)。在由联合ER和PR状态定义的四种亚型中,两个数据来源之间对于两种主要乳腺癌亚型(ER - /PR - ,kappa = 0.69;ER + /PR + ,kappa = 0.62)的一致性很强,而对于两种较罕见的亚型(ER + /PR - ,kappa = 0.30;ER - /PR + ,kappa = 0.05)则较差。生殖因素(足月妊娠次数、首次足月妊娠年龄和母乳喂养持续时间)与两种主要亚型(ER + /PR + 和ER - /PR - )之间关联的估计在两个数据来源之间差异极小。例如,至少有四次足月妊娠的经产妇患ER + /PR + 乳腺癌的风险比从未怀孕的女性低40%[中央实验室,比值比,0.60(95%置信区间为0.39 - 0.92);SEER,比值比,0.57(95%置信区间为0.38 - 0.85)];未观察到ER - /PR - 乳腺癌有相关性(两者P趋势均> 0.30)。我们的结果表明,基于SEER登记处数据得出的结论对于ER + /PR + 和ER - /PR - 亚型来说相当可靠。