Sun Yan, Nie Gang, Wei Zhimin, Lv Zhidong, Liu Xiaoyi, Wang Haibo
Breast Center, Qingdao University Affiliated Hospital, No. 59 of Haier Road, Qingdao, 266000, China.
Med Oncol. 2014 Jul;31(7):55. doi: 10.1007/s12032-014-0055-z. Epub 2014 Jun 17.
The classification of luminal breast cancer has been a popular topic regarding its heterogeneity with distinct biological features and clinical outcomes. This study aimed to assess the power of proliferative indices (Ki67 and histological grade) to determine various clinicopathological characteristics and survival in luminal disease. A total of 541 patients with stage I-III luminal breast cancer were enrolled. Subtypes were determined using proliferative indices and were compared with clinicopathological variables and short-term survival. The significance of various treatments was evaluated in a subgroup of pN0 (lymph node negative) patients. Histological grade, independent of other variables, was a better predictor in the ER/PR+, human epidermal growth factor receptor 2 (Her-2) subgroup (p = 0.011) and the pN0 subgroup (p = 0.044) compared with Ki67, which only showed significance in the ER/PR+, Her-2 subgroup (p = 0.008). Neither grade nor Ki67 was associated with outcomes in the luminal Her-2 class. In pN0 patients, various treatments did not show significance in short-term survival. Histological grade outperformed Ki67 as a determinant for the stratification of luminal class regarding short-term survival. Chemotherapy most likely did not provide additional benefit to pN0 patients with luminal breast cancer compared with endocrine therapy.
管腔型乳腺癌的分类一直是一个热门话题,因为其具有不同的生物学特征和临床结局的异质性。本研究旨在评估增殖指数(Ki67和组织学分级)在确定管腔型疾病的各种临床病理特征和生存情况方面的作用。共纳入了541例I-III期管腔型乳腺癌患者。使用增殖指数确定亚型,并与临床病理变量和短期生存情况进行比较。在pN0(淋巴结阴性)患者亚组中评估了各种治疗方法的意义。与Ki67相比,组织学分级独立于其他变量,在雌激素受体/孕激素受体阳性(ER/PR+)、人表皮生长因子受体2(Her-2)亚组(p = 0.011)和pN0亚组(p = 0.044)中是更好的预测指标,而Ki67仅在ER/PR+、Her-2亚组中具有显著性(p = 0.008)。在管腔型Her-2类别中,分级和Ki67均与结局无关。在pN0患者中,各种治疗方法在短期生存方面均无显著性差异。在管腔型短期生存分层方面,组织学分级作为决定因素优于Ki67。与内分泌治疗相比,化疗对pN0管腔型乳腺癌患者可能没有额外益处。