Tawfik Ossama, Davis Keisha, Kimler Bruce F, Davis Marilyn K, Hull Stephanie, Fan Fang, Khan Qamar J, O'Dea Anne P, Thomas Patricia
Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, 66160, USA.
Ann Clin Lab Sci. 2010 Fall;40(4):315-23.
African-American (AA) women are more likely to have late stage, aggressive, rapidly growing, and less hormone-responsive breast tumors. An aggressive subtype of cancer, known as "Triple-Negative" (TN), that is negative for Her-2 and for estrogen and progesterone receptors (ER and PR), is reported to be more common in AA women. We examined the clinical, histopathologic, and prognostic features of TN tumors in AA and Caucasian women. Tumor size, grade, histologic type, lymphovascular invasion (LVI), lymph node status, patient survival, ploidy status, and expression of ER, PR, p53, epidermal growth factor receptor (EGFR), MIB-1, Bcl-2, Her-2, p27, and p21 were evaluated. The TN tumors (75%) were high grade, large, aneuploid tumors that occurred in younger women and were more likely to have a high rate of LVI, elevated MIB-1 score, and nodal metastases. Patients with TN tumors showed poorer overall survival. There was no difference in overall or disease-free survival (p = 0.46) in the AA versus Caucasian women. LVI was a significant predictor of overall survival in AA but not in Caucasian women. There were minor differences in histopathologic features, biomarker expressions, and survival in AA and Caucasian women with TN tumors. The absence of LVI in AA patients predicted an excellent probability of survival.
非裔美国(AA)女性更易患晚期、侵袭性强、生长迅速且激素反应性较低的乳腺肿瘤。一种侵袭性癌症亚型,即所谓的“三阴性”(TN),其Her-2、雌激素和孕激素受体(ER和PR)均呈阴性,据报道在AA女性中更为常见。我们研究了AA女性和白人女性中TN肿瘤的临床、组织病理学和预后特征。评估了肿瘤大小、分级、组织学类型、淋巴管浸润(LVI)、淋巴结状态、患者生存率、倍体状态以及ER、PR、p53、表皮生长因子受体(EGFR)、MIB-1、Bcl-2、Her-2、p27和p21的表达。TN肿瘤(75%)为高级别、体积大、非整倍体肿瘤,多见于年轻女性,更易出现高LVI率、MIB-1评分升高和淋巴结转移。TN肿瘤患者的总体生存率较差。AA女性和白人女性在总体生存率或无病生存率方面无差异(p = 0.46)。LVI是AA女性总体生存的重要预测因素,但在白人女性中并非如此。AA女性和白人女性的TN肿瘤在组织病理学特征、生物标志物表达和生存率方面存在细微差异。AA患者无LVI预示着极好的生存概率。