Jacobson-Raber Galia, Lazarev Irena, Novack Victor, Mermershtein Willmosh, Baumfeld Yael, Geffen David B, Sion-Vardy Netta, Ariad Samuel
Department of Oncology, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheva 84101, Israel.
Oncol Lett. 2011 Nov;2(6):1183-1190. doi: 10.3892/ol.2011.393. Epub 2011 Aug 24.
Molecular tools have increasingly been used for decision-making in patients with early breast cancer (EBC). Nevertheless, simple tools such as immunohistochemistry may still be required in particular cases to complement traditional and molecular prognosticators. In this study, the prognostic significance of three well-known immunohistochemical biomarkers, cathepsin D, E-cadherin and Ki67, was studied in 270 patients with EBC, followed by a median time of 126 months in a single institution. Histological examination was performed to confirm the histopathological diagnosis and select specimens. The specimens were evaluated using immunohistochemistry and survival curves were plotted. Results revealed the following patient characteristics: node-negative/1-3 lymph nodes in 228 (86%) patients, hormone receptor-positive in 217 (80%); triple-negative in 31 (11%), and Her2-overexpression in 23 (9%) patients. Breast cancer-related events occurred in 37 patients (14%). A total of 217 patients (80%) survived. Receiver operating characteristic analysis for breast cancer-specific survival showed an area under curve for the clinicopathological model of 0.75 (95% CI, 0.64-0.86), 0.79 (95% CI, 0.68-0.90) for the three-biomarker model, and 0.82 (95% CI, 0.72-0.92) for the E-cadherin and cathepsin D only model. We propose that a simple prognostic model based on combined scores of E-cadherin and cathepsin D may aid treatment decisions in patients with EBC.
分子工具越来越多地用于早期乳腺癌(EBC)患者的决策制定。然而,在某些特定情况下,可能仍需要诸如免疫组织化学等简单工具来补充传统和分子预后指标。在本研究中,对270例EBC患者研究了三种著名的免疫组织化学生物标志物组织蛋白酶D、E-钙黏蛋白和Ki67的预后意义,这些患者在单一机构中位随访时间为126个月。进行组织学检查以确认组织病理学诊断并选择标本。使用免疫组织化学对标本进行评估并绘制生存曲线。结果显示了以下患者特征:228例(86%)患者为淋巴结阴性/1 - 3个淋巴结,217例(80%)激素受体阳性;31例(11%)为三阴性,23例(9%)患者为Her2过表达。37例患者(14%)发生了乳腺癌相关事件。共有217例患者(80%)存活。乳腺癌特异性生存的受试者工作特征分析显示,临床病理模型的曲线下面积为0.75(95%CI,0.64 - 0.86),三种生物标志物模型为0.79(95%CI,0.68 - 0.90),仅E-钙黏蛋白和组织蛋白酶D模型为0.82(95%CI,0.72 - 0.92)。我们提出,基于E-钙黏蛋白和组织蛋白酶D综合评分的简单预后模型可能有助于EBC患者的治疗决策。