Zaha Dana Carmen, Lazăr Elena, Lăzureanu Codruţa
Preclinic I Department, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania.
Rom J Morphol Embryol. 2010;51(1):85-9.
In the last years, the incidence of breast cancer has been increasing; characteristic patterns of gene expression have emerged, reflecting molecular differences between previously known as well as newly defined subtypes of breast cancer. This study aimed to classify the molecular subtypes of breast cancers based on the expression profile of immunohistochemical markers and to evaluate their association with clinicopathological features.
A total of 173 cases of breast carcinoma were examined retrospectively using immunostains for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2). Because the triple-negative phenotype, when defined by IHC using only these three markers, is not the optimal method for defining basal-like breast cancer, we need to use an additional marker--CK 5/6.
The luminal type was the most common subtype in breast cancer (71.6%), which was followed by the basal subtype (21.9%). HER2 subtype were 2.8% from the total of cases, being associated with the highest rate of high-graded cases. Basal type is presented largely in premenopausal women and displayed aggressive features, such as large tumor size and poorly differentiated cancers. Luminal A included the highest percentage of patients older than 60 years, the highest proportion of stage I-II tumors and well/moderately differentiated lesions. HER2-type was more frequent in premenopausal women and showed a high percentage of positive lymph nodes.
These molecular differences have been shown to correlate very well with clinical features and survival, or even better than traditional histopathological parameters. The discovery of certain molecular characteristics of breast cancers has helped us to understand better the pathophysiology of disease and to develop more direct therapeutic strategies.
在过去几年中，乳腺癌的发病率一直在上升；已出现特征性的基因表达模式，反映了先前已知以及新定义的乳腺癌亚型之间的分子差异。本研究旨在根据免疫组化标志物的表达谱对乳腺癌的分子亚型进行分类，并评估它们与临床病理特征的相关性。
回顾性检查了173例乳腺癌病例，使用雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）的免疫染色。由于仅使用这三种标志物通过免疫组化定义的三阴性表型并非定义基底样乳腺癌的最佳方法，因此我们需要使用额外的标志物——细胞角蛋白5/6（CK 5/6）。
管腔型是乳腺癌中最常见的亚型（71.6%），其次是基底亚型（21.9%）。HER2亚型占病例总数的2.8%，与高级别病例的发生率最高相关。基底型主要出现在绝经前女性中，并表现出侵袭性特征，如肿瘤体积大、分化差的癌症。管腔A型中年龄大于60岁的患者比例最高，I-II期肿瘤以及高分化/中分化病变的比例最高。HER2型在绝经前女性中更常见，且阳性淋巴结比例较高。
这些分子差异已被证明与临床特征和生存率密切相关，甚至比传统的组织病理学参数更好。乳腺癌某些分子特征的发现有助于我们更好地理解疾病的病理生理学，并制定更直接的治疗策略。
