Sharif Muhammad Ashraf, Mamoon Nadira, Mushtaq Sajid, Khadim Muhammad Tahir
Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi.
J Coll Physicians Surg Pak. 2010 Sep;20(9):590-4.
To determine age-related association of Her-2/neu expression with histological and immunohistochemical prognostic markers in female breast carcinoma.
Cross sectional, observational study.
Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2004 to December 2007.
Patients of primary operable female breast carcinoma were categorised as < 40 years (pre-menopausal), 41-50 years (peri-menopausal) and > 50 years (post-menopausal) age groups. Histological type, tumour size, tumour grade and lymph node status were determined while estrogen receptor (ER), progesterone receptor (PR) and Her-2/neu expression were evaluated immunohistochemically. Association of Her-2/neu with histological and immnuohistochemical prognostic markers was determined in pre-menopausal, peri-menopausal and post- menopausal age groups using the x2 test for uni- and multivariate analysis.
Out of the 722 patients, 230 (31.9%) were in pre-menopausal, 221 (30.6%) in peri-menopausal and 271 (37.5%) in post-menopausal age group. Infiltrating ductal carcinoma was the pre-dominant subtype in all the age groups. Mean tumour size was 4.3+/-2.3 cm (range 0.4-17 cm) and lymph node metastasis was seen in 310 (70.8%) cases. Her-2/neu showed association with ER in the all the age groups while PR only showed association in the peri-menopausal and postmenopausal women. Her-2/neu showed no association with tumour size, tumor grade and lymph node metastases in pre-menopausal and peri-menopausal women while it showed positive association with tumour size and lymph node metastasis in the post-menopausal women (p < 0.05).
Majority (62%) patients were under 50 years as against the Western epidemiology. Association of Her-2/neu with ER, PR, tumour size and lymph node metastasis was age related as pre-menopausal, peri-menopausal and postmenopausal had variable expression of these prognostic markers with therapeutic and prognostic implications.
确定女性乳腺癌中Her-2/neu表达与组织学及免疫组化预后标志物的年龄相关性。
横断面观察性研究。
2004年1月至2007年12月，拉瓦尔品第武装部队病理研究所组织病理学系。
将原发性可手术女性乳腺癌患者分为年龄小于40岁（绝经前）、41 - 50岁（围绝经期）和大于50岁（绝经后）三组。确定组织学类型、肿瘤大小、肿瘤分级和淋巴结状态，同时通过免疫组化评估雌激素受体（ER）、孕激素受体（PR）和Her-2/neu表达。采用卡方检验对绝经前、围绝经期和绝经后年龄组进行单因素和多因素分析，以确定Her-2/neu与组织学及免疫组化预后标志物的相关性。
722例患者中，230例（31.9%）为绝经前患者，221例（30.6%）为围绝经期患者，271例（37.5%）为绝经后患者。浸润性导管癌是所有年龄组中的主要亚型。平均肿瘤大小为4.3±2.3 cm（范围0.4 - 17 cm），310例（70.8%）病例出现淋巴结转移。Her-2/neu在所有年龄组中均与ER相关，而PR仅在围绝经期和绝经后女性中显示出相关性。在绝经前和围绝经期女性中，Her-2/neu与肿瘤大小、肿瘤分级和淋巴结转移无关，而在绝经后女性中，它与肿瘤大小和淋巴结转移呈正相关（p < 0.05）。
与西方流行病学情况不同，大多数（62%）患者年龄在50岁以下。Her-2/neu与ER、PR、肿瘤大小和淋巴结转移的相关性与年龄有关，因为绝经前、围绝经期和绝经后这些预后标志物的表达不同，具有治疗和预后意义。
