Hisamatsu Yuichi, Tokunaga Eriko, Yamashita Nami, Akiyoshi Sayuri, Okada Satoko, Nakashima Yuichiro, Taketani Kenji, Aishima Shinichi, Oda Yoshinao, Morita Masaru, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
Breast Cancer. 2015 Sep;22(5):520-8. doi: 10.1007/s12282-013-0515-x. Epub 2014 Jan 11.
Determining the indications for adjuvant chemotherapy (CT) in patients with hormone receptor (HR)-positive/HER2-negative breast cancer are difficult. The transcription factors GATA-binding protein 3 (GATA-3) and Forkhead-box protein A1 (FOXA1) are crucial for the hormone responsive phenotype of breast cancer. This study evaluated whether the expression of GATA-3 and FOXA1 is a prognostic and predictive marker of outcomes in patients with HR-positive/HER2-negative breast cancer.
The expression of GATA-3 and FOXA1 was analyzed immunohistochemically in 214 patients with invasive breast cancer to evaluate the association with the clinicopathological features and the prognosis.
GATA-3 expression was positively correlated with FOXA1 expression (P < 0.0001). Both GATA-3 and FOXA1 were positively correlated with ER (P < 0.0001 each) and PR expression (P = 0.0001 and P = 0.0009, respectively), and inversely correlated with nuclear grade (P = 0.0002 and P = 0.0018, respectively) and Ki67 index (P = 0.0052 and P = 0.0049, respectively). Expression of GATA-3 and FOXA1 was associated with better prognosis. FOXA1 was an independent favorable prognostic marker in HR-positive/HER2-negative breast cancer. Disease-free survival rates were similar in patients with HR-positive/HER2-negative breast cancer and high FOXA1 expression given adjuvant hormone therapy (HT) alone and those given CT plus HT.
GATA-3 and FOXA1 are associated with a less aggressive phenotype and a better prognosis in patients with HR-positive/HER2-negative breast cancer. FOXA1 may be useful in identifying those patients who may not require adjuvant CT.
确定激素受体（HR）阳性/人表皮生长因子受体2（HER2）阴性乳腺癌患者辅助化疗（CT）的指征较为困难。转录因子GATA结合蛋白3（GATA-3）和叉头框蛋白A1（FOXA1）对乳腺癌的激素反应表型至关重要。本研究评估GATA-3和FOXA1的表达是否为HR阳性/HER2阴性乳腺癌患者预后和结局的预测标志物。
对214例浸润性乳腺癌患者进行免疫组织化学分析，以评估GATA-3和FOXA1的表达与临床病理特征及预后的相关性。
GATA-3表达与FOXA1表达呈正相关（P<0.0001）。GATA-3和FOXA1均与雌激素受体（ER）（均P<0.0001）和孕激素受体（PR）表达呈正相关（分别为P=0.0001和P=0.0009），与核分级呈负相关（分别为P=0.0002和P=0.0018）以及与Ki67指数呈负相关（分别为P=0.0052和P=0.0049）。GATA-3和FOXA1的表达与较好的预后相关。FOXA1是HR阳性/HER2阴性乳腺癌独立的有利预后标志物。仅接受辅助激素治疗（HT）以及接受CT加HT的HR阳性/HER2阴性且FOXA1高表达的乳腺癌患者无病生存率相似。
GATA-3和FOXA1与HR阳性/HER2阴性乳腺癌患者侵袭性较低的表型及较好的预后相关。FOXA1可能有助于识别那些可能不需要辅助CT的患者。
