Petricević Josko, Petković Marija, Jonjić Nives
School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
Acta Clin Croat. 2011 Jun;50(2):169-75.
Determination of hormone receptors is of utmost importance in planning therapy in patients with breast cancer. The aim of the study was to assess the expression of estrogen (ER) and progesterone (PR) receptors in ductal invasive breast carcinoma not otherwise specified (NOS) according to patient menopausal state and tumor histopathology. The study included 549 patients treated at University Department of Surgery, Rijeka University Hospital Center, between January 1, 2000 andJanuary 1, 2005. The patients were diagnosed with breast cancer and underwent mastectomy. ER and PR status was determined by immunohistochemistry. Study results showed no statistically significant differences in the expression of ER and PR, tumor size and grade of histologic differentiation between premenopausal and postmenopausal women. However, tumor size and grade of histologic differentiation differed significantly according to the expression of hormone receptors. Tumors greater than 5 cm in size were mostly ER- in premenopausal (P = 0.012) and PR- in postmenopausal (P = 0.044) patients. Poorly differentiated cancers were associated with ER-PR-status in both premenopausal and postmenopausal patients (P < 0.001). Hormone dependent tumors (ER+PR+) were of smaller diameter and lower histologic grade, while hormone independent tumors (ER-PR-) had greater diameter and higher histologic grade, the difference being statistically significant (P = 0.004 and P < 0.001, respectively). Study results on the characteristics of ductal invasive carcinoma according to hormone status were consistent with those described in the literature. Considering controversies about the role of steroid receptors in endocrine therapy response, our future objective is assessment of the 5-year prognosis in our patients.
激素受体的测定对于乳腺癌患者治疗方案的制定至关重要。本研究旨在根据患者的绝经状态和肿瘤组织病理学评估未另行规定(NOS)的导管浸润性乳腺癌中雌激素(ER)和孕激素(PR)受体的表达情况。该研究纳入了2000年1月1日至2005年1月1日期间在里耶卡大学医院中心外科大学部接受治疗的549例患者。这些患者被诊断为乳腺癌并接受了乳房切除术。ER和PR状态通过免疫组织化学确定。研究结果显示,绝经前和绝经后女性在ER和PR表达、肿瘤大小及组织学分化程度方面无统计学显著差异。然而,根据激素受体的表达情况,肿瘤大小和组织学分化程度存在显著差异。在绝经前患者中,肿瘤大小大于5 cm的大多为ER阴性(P = 0.012),在绝经后患者中大多为PR阴性(P = 0.044)。在绝经前和绝经后患者中,低分化癌均与ER-PR状态相关(P < 0.001)。激素依赖性肿瘤(ER+PR+)直径较小且组织学分级较低,而激素非依赖性肿瘤(ER-PR-)直径较大且组织学分级较高,差异具有统计学意义(分别为P = 0.004和P < 0.001)。根据激素状态对导管浸润癌特征的研究结果与文献报道一致。考虑到关于类固醇受体在内分泌治疗反应中作用的争议,我们未来的目标是评估我们患者的5年预后。