Department of Pathology, Ford Health System, Detroit, Michigan, USA.
Cancer. 2010 Nov 1;116(21):4926-32. doi: 10.1002/cncr.25276.
The study of breast cancer in women with African ancestry offers the promise of identifying markers for risk assessment and treatment of triple-negative disease.
African American and white American women with invasive cancer diagnosed at the Henry Ford Health System comprised the primary study population, and Ghanaian patients diagnosed and/or treated at the Komfo Anokye Teaching Hospital in Kumasi, Ghana constituted the comparison group. Formalin-fixed, paraffin-embedded specimens were transported to the University of Michigan for histopathology confirmation, and assessment of estrogen and progesterone receptors and HER-2/neu expression.
The study population included 1008 white Americans, 581 African Americans, and 75 Ghanaians. Mean age at diagnosis was 48.0 years for Ghanaian, 60.8 years for African American, and 62.4 for white American cases (P=.002). Proportions of Ghanaian, African American, and white American cases with estrogen receptor-negative tumors were 76%, 36%, and 22%, respectively (P<.001), and proportions with triple-negative disease were 82%, 26%, and 16%, respectively (P<.001). All Ghanaian cases were palpable, locally advanced cancers; 57 (76%) were grade 3. A total of 147 American women were diagnosed as stage III or IV; of these, 67.5% (n=46) of African Americans and 44.6% (n=29) of white Americans were grade 3. Among palpable, grade 3 cancers, Ghanaians had the highest prevalence of triple-negative tumors (82.2%), followed by African Americans (32.8%) and white Americans (10.2%).
Our study demonstrates progressively increasing frequency of estrogen receptor-negative and triple-negative tumors among breast cancer patients with white American, African American, and Ghanaian/African backgrounds. This pattern indicates a need for additional investigations correlating the extent of African ancestry and high-risk breast cancer subtypes.
对非洲裔女性乳腺癌的研究有望确定风险评估和三阴性疾病治疗的标志物。
本研究的主要研究人群包括在亨利福特健康系统诊断为浸润性癌的非裔美国人和白人美国女性，加纳患者在加纳库马西的 Komfo Anokye 教学医院诊断和/或治疗构成了对照组。福尔马林固定、石蜡包埋的标本被运送到密歇根大学进行组织病理学确认，并评估雌激素和孕激素受体以及 HER-2/neu 的表达。
研究人群包括 1008 名白人美国人、581 名非裔美国人和 75 名加纳人。加纳、非裔美国人和白人美国患者的诊断时平均年龄分别为 48.0 岁、60.8 岁和 62.4 岁（P=.002）。加纳、非裔美国人和白人美国患者中雌激素受体阴性肿瘤的比例分别为 76%、36%和 22%（P<.001），三阴性疾病的比例分别为 82%、26%和 16%（P<.001）。所有加纳病例均为可触及的局部晚期癌症；57 例（76%）为 3 级。共有 147 名美国女性被诊断为 III 期或 IV 期；其中，67.5%（n=46）的非裔美国人和 44.6%（n=29）的白人美国人为 3 级。在可触及的 3 级癌症中，加纳人的三阴性肿瘤比例最高（82.2%），其次是非裔美国人（32.8%）和白人美国人（10.2%）。
我们的研究表明，具有白种人、非裔美国人和加纳/非洲背景的乳腺癌患者中，雌激素受体阴性和三阴性肿瘤的频率逐渐增加。这种模式表明需要进一步研究，以确定非洲血统的程度与高危乳腺癌亚型之间的关系。
