Department of Breast Surgery, Hospital do Câncer- A C Camargo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2011;66(4):607-12. doi: 10.1590/s1807-59322011000400014.
Breast tumors exhibit extensive molecular and clinical heterogeneity. One of the most utilized breast carcinoma classifications is based on its molecular aspects and subdivides breast cancer into five major groups based on the expression of certain genes. In this study, we evaluated which factors are important in determining a prognosis after 5 years of follow-up for patients with clinical stage IIA breast tumors. We took into consideration the different phenotypes (luminal A luminal B HER-2 overexpression, basal and triple-negative), various epithelial-mesenchymal (EMT) molecular markers and adhesion molecules (E-cadherin, P-cadherin, N-cadherin, vimentin, twist snail and slug) and NOS-2, in addition to clinical and demographic data, tumor characteristics and treatment types.
The study population consisted of 82 patients with breast cancer. We analyzed eight molecular markers by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with ten years of follow-up, and we classified each tumor according to its estrogen receptor, progesterone receptor and HER-2 expression. We then placed the tumor into one of the above categories.
The presence of several clinical and demographic factors, various histopathologies, treatment forms and several immunohistochemical markers were not associated with a worse prognosis for group IIA patients. The factors that were associated with a mortality risk were the triple-negative (odds ratio (OR) = 11.8, 95% confident interval (CI) = 2.0-70.3, P = 0.007) and basal (OR =18.4, 95% CI = 1.8-184.7, P= 0.013) phenotypic patterns.
The EMT markers and NOS-2 were not mortality risk factors. Basal and triple-negative phenotypic patterns were related to a higher mortality risk in patients with stage IIA tumors.
乳腺肿瘤表现出广泛的分子和临床异质性。最常用的乳腺癌分类之一是基于其分子方面，根据某些基因的表达将乳腺癌分为五个主要组。在这项研究中，我们评估了哪些因素对临床 IIA 期乳腺肿瘤患者 5 年随访后的预后具有重要意义。我们考虑了不同的表型（luminal A、luminal B、HER-2 过表达、基底型和三阴性）、各种上皮-间充质（EMT）分子标志物和黏附分子（E-钙黏附蛋白、P-钙黏附蛋白、N-钙黏附蛋白、波形蛋白、twist、snail 和 slug）以及 NOS-2，此外还有临床和人口统计学数据、肿瘤特征和治疗类型。
研究人群包括 82 例乳腺癌患者。我们通过免疫组织化学分析了组织微阵列中的 8 种分子标志物，该微阵列包含了 10 年随访的乳腺癌患者的肿瘤标本，并根据雌激素受体、孕激素受体和 HER-2 的表达对每个肿瘤进行分类。然后，我们将肿瘤归入上述类别之一。
存在几种临床和人口统计学因素、各种组织病理学、治疗形式和几种免疫组织化学标志物与 IIA 组患者的预后较差无关。与死亡率风险相关的因素是三阴性（比值比（OR）=11.8，95%置信区间（CI）=2.0-70.3，P=0.007）和基底型（OR=18.4，95%CI=1.8-184.7，P=0.013）表型模式。
EMT 标志物和 NOS-2 不是死亡风险因素。基底型和三阴性表型模式与 IIA 期肿瘤患者的更高死亡率相关。
