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乳腺癌分子亚型与临床病理特征及预后的关系

[Relationship between breast cancer molecular subtypes with clinicopathological characteristics and prognosis].

作者信息

Lin Min, Chen Zhong-qing, Bao Yun, Li Qiong, Du Zun-guo, Xu Zu-de, Tang Feng

机构信息

Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2010 Jun;39(6):372-6.

Abstract

OBJECTIVES

This study try to subclassify breast cancer into different prognostic subgroups according to immunohistochemical algorithm and discuss the relationship between subtypes and biological and clinical behavior and prognosis.

METHODS

One hundred and twenty-eight cases of infiltrative ductal carcinoma were studied using immunohistochemical staining with an antibody panel of ER, PR, HER2 and CK5/6 and subclassified referring to previous reports, and the 9 cases of HER2 positive subtype were tested using FISH.

RESULTS

The expression of ER, PR, HER2, and CK5/6 was detected in 67%, 45%, 27% and 27% cases, respectively. All cases were subclassified into five subgroups, with luminal A (55%), luminal B (20%), HER2 positive (7%), basal-like (10%) and unclassified cases (8%). Nine HER2 positive cases all showed amplification of HER2 gene. It was demonstrated that the luminal A group was associated with the best prognosis but the basal-like group worst by univariate analysis. Multivariate analysis demonstrated that both the clinical stage and immunohistochemical subtypes of tumor were related to overall survival. Menses status were different among these subtypes.

CONCLUSION

According to the expression of ER, PR, HER2 and CK5/6, infiltrative ductal carcinoma could be subclassified into five subgroups with different biological features and outcome, having a role in evaluating the prognosis and guiding the clinical treatment.

摘要

目的

本研究试图根据免疫组化算法将乳腺癌细分为不同的预后亚组,并探讨各亚型与生物学行为、临床行为及预后之间的关系。

方法

采用雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)及细胞角蛋白5/6(CK5/6)抗体组合进行免疫组化染色,对128例浸润性导管癌病例进行研究,并参照既往报道进行亚组分类,对9例HER2阳性亚型病例采用荧光原位杂交(FISH)检测。

结果

ER、PR、HER2及CK5/6的表达分别在67%、45%、27%及27%的病例中检测到。所有病例被细分为五个亚组,即腔面A型(55%)、腔面B型(20%)、HER2阳性型(7%)、基底样型(10%)及未分类病例(8%)。9例HER2阳性病例均显示HER2基因扩增。单因素分析表明,腔面A型预后最佳,而基底样型最差。多因素分析表明,肿瘤的临床分期及免疫组化亚型均与总生存相关。这些亚型之间月经状态存在差异。

结论

根据ER、PR、HER2及CK5/6的表达,浸润性导管癌可细分为五个具有不同生物学特征及转归的亚组,对评估预后及指导临床治疗具有重要意义。

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