Pinto António E, Areia Filipa, Pereira Teresa, Cardoso Paula, Aparício Mariana, Silva Giovani L, Ferreira Mónica C, André Saudade
Departamento de Matemática do Instituto Superior Técnico da Universidade Técnica de Lisboa, Lisboa, Portugal.
Springerplus. 2013 Aug 9;2:375. doi: 10.1186/2193-1801-2-375. eCollection 2013.
Accurate assessment of estrogen (ER) and progesterone (PR) receptors is critical in predicting the response to endocrine therapies in breast cancer.
From a series of 360 patients with breast invasive carcinoma assessed for hormone receptors by immunohistochemistry (IHC) in the 90's, we re-analysed, on the same tumour material, the cases considered negative (n = 164), i.e., ER-/PR- (n = 95), ER+/PR- (n = 63) and ER-/PR+ (n=6), and 16 of 196 ER+/PR+ tumours with unfavourable outcome. Concordance between the previous IHC (Streptavidin-Biotin-Peroxidase) method and the current one (Peroxidase-Indirect-Polymer) was determined by the McNemar's test. Relapse-free (RFS) and overall survival (OS) were estimated by the Kaplan-Meier method.
From 101 ER- and 158 PR- cases, 38 (37.6%) and 58 (36.7%) became positive, increasing ER and PR expression from 71.9% and 56.1% to 82.5% and 72.2%, respectively (P<0.001). All 16 ER+/PR+ cases maintained their co-positivity, while all ER-/PR+ tumours changed to ER positive. Kaplan-Meier survival curves showed significant differences related to RFS and OS for PR, either in the whole series or in the subset (n = 151) submitted to hormonal treatment. The patients' subgroup with ER+/PR- tumours exhibited the worst prognosis.
The current IHC method improves the clinical usefulness of ER/PR assessment by decreasing the rate of false negative results.
准确评估雌激素（ER）和孕激素（PR）受体对于预测乳腺癌内分泌治疗的反应至关重要。
在90年代通过免疫组织化学（IHC）对360例乳腺浸润癌患者进行激素受体评估，我们在相同肿瘤材料上重新分析了被认为阴性的病例（n = 164），即ER - /PR - （n = 95）、ER + /PR - （n = 63）和ER - /PR + （n = 6），以及196例ER + /PR + 且预后不良的肿瘤中的16例。通过McNemar检验确定先前的IHC（链霉亲和素 - 生物素 - 过氧化物酶）方法与当前方法（过氧化物酶 - 间接 - 聚合物）之间的一致性。通过Kaplan - Meier方法估计无复发生存期（RFS）和总生存期（OS）。
在101例ER - 和158例PR - 的病例中，分别有38例（37.6%）和58例（36.7%）变为阳性，ER和PR表达分别从71.9%和56.1%增加到82.5%和72.2%（P<0.001）。所有16例ER + /PR + 病例保持其双阳性，而所有ER - /PR + 肿瘤变为ER阳性。Kaplan - Meier生存曲线显示，无论是在整个系列中还是在接受激素治疗的亚组（n = 151）中，PR与RFS和OS均存在显著差异。ER + /PR - 肿瘤患者亚组预后最差。
当前的IHC方法通过降低假阴性结果率提高了ER/PR评估的临床实用性。
