Duchnowska Renata, Dziadziuszko Rafał, Trojanowski Tomasz, Mandat Tomasz, Och Waldemar, Czartoryska-Arłukowicz Bogumiła, Radecka Barbara, Olszewski Wojciech, Szubstarski Franciszek, Kozłowski Wojciech, Jarosz Bożena, Rogowski Wojciech, Kowalczyk Anna, Limon Janusz, Biernat Wojciech, Jassem Jacek
Breast Cancer Res. 2012 Aug 16;14(4):R119. doi: 10.1186/bcr3244.
We investigated the status of estrogen receptor alpha (ERα), progesterone receptor (PR), and epidermal growth factor receptor 2 (HER2) in primary tumor and in the corresponding brain metastases in a consecutive series of breast cancer patients. Additionally, we studied factors potentially influencing conversion and evaluated its association with survival.
The study group included 120 breast cancer patients. ERα, PR, and HER2 status in primary tumors and in matched brain metastases was determined centrally by immunohistochemistry and/or fluorescence in situ hybridization.
Using the Allred score of ≥ 3 as a threshold, conversion of ERα and PR in brain metastases occurred in 29% of cases for both receptors, mostly from positive to negative. Conversion of HER2 occurred in 14% of patients and was more balanced either way. Time to brain relapse and the use of chemotherapy or trastuzumab did not influence conversion, whereas endocrine therapy induced conversion of ERα (P = 0.021) and PR (P = 0.001), mainly towards their loss. Receptor conversion had no significant impact on survival.
Receptor conversion, particularly loss of hormone receptors, is a common event in brain metastases from breast cancer, and endocrine therapy may increase its incidence. Receptor conversion does not significantly affect survival.
我们研究了一系列连续乳腺癌患者原发性肿瘤及相应脑转移瘤中雌激素受体α（ERα）、孕激素受体（PR）和表皮生长因子受体2（HER2）的状态。此外，我们研究了可能影响转化的因素，并评估了其与生存的相关性。
研究组包括120例乳腺癌患者。原发性肿瘤及配对脑转移瘤中的ERα、PR和HER2状态通过免疫组织化学和/或荧光原位杂交集中测定。
以≥3的Allred评分为阈值，脑转移瘤中ERα和PR的转化在两种受体中均发生于29%的病例，大多从阳性转为阴性。HER2的转化发生于14%的患者，且两种方向更为均衡。脑复发时间以及化疗或曲妥珠单抗的使用均不影响转化，而内分泌治疗诱导了ERα（P = 0.021）和PR（P = 0.001）的转化，主要是向其缺失方向转化。受体转化对生存无显著影响。
受体转化，尤其是激素受体的缺失，在乳腺癌脑转移中是常见事件，内分泌治疗可能增加其发生率。受体转化对生存无显著影响。
