Wang Jin, Zhang Xinke, He Jiehua, Yang Mingtian, Tang Jun, Li Xing, Tang Hailin, Xie Xiaoming
Department of Breast Oncology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China,
Med Oncol. 2014 Sep;31(9):172. doi: 10.1007/s12032-014-0172-8. Epub 2014 Aug 15.
Primary squamous cell carcinoma of the breast (PSCCB) is an extremely rare breast tumor lacking hormone receptors and HER2 expression. However, in comparison with triple-negative invasive ductal carcinoma (TN-IDC), little is known about the PSCCB. Twenty-nine patients with PSCCB in Sun Yat-sen University Cancer Center from 1995 to 2010 were recruited in this study, along with 681 cases of TN-IDC during the same period. The clinicopathologic features and prognosis of PSCCB compared to TN-IDC were assessed. Furthermore, biomarkers of EGFR, CK5/6, E-cadherin, VEGF, TOPII, and p53 were immunostained to investigate the prognostic determinant of PSCCB. Patients with PSCCB were older than those with TN-IDC (P = 0.009) and presented with lower lymph node involvement (P = 0.015). There was no difference in overall survival (OS) between PSCCB and TN-IDC. However, the disease-free survival (DFS) of PSCCB was poorer than that of TN-IDC (P = 0.007). Multivariate analysis revealed that combined over-expression of EGFR and CK5/6 was the only independent prognostic factor for OS of PSCCB (HR 6.08, 95 % CI 1.33-27.85, P = 0.020) and associated with lymphatic metastasis (P = 0.023) and p53 expression (P = 0.013). Other predictors for poorer OS and DFS were lymphatic metastasis and stage III, which failed to show significance after multivariate analysis. Furthermore, platinum-based chemotherapy was identified to improve the OS of PSCCB with EGFR + CK5/6+ (P = 0.027). The prognosis of PSCCB is poorer than that of TN-IDC. As the only independent prognostic factor for PSCCB, combined over-expression of EGFR and CK5/6 might be a potential indicator for the use of platinum-based chemotherapy.
乳腺原发性鳞状细胞癌（PSCCB）是一种极其罕见的乳腺肿瘤，缺乏激素受体和HER2表达。然而，与三阴性浸润性导管癌（TN-IDC）相比，人们对PSCCB知之甚少。本研究纳入了1995年至2010年中山大学肿瘤防治中心的29例PSCCB患者，以及同期的681例TN-IDC患者。评估了PSCCB与TN-IDC相比的临床病理特征和预后。此外，对表皮生长因子受体（EGFR）、细胞角蛋白5/6（CK5/6）、E-钙黏蛋白、血管内皮生长因子（VEGF）、拓扑异构酶II（TOPII）和p53等生物标志物进行免疫染色，以研究PSCCB的预后决定因素。PSCCB患者比TN-IDC患者年龄更大（P = 0.009），且淋巴结受累情况更低（P = 0.015）。PSCCB和TN-IDC的总生存期（OS）没有差异。然而，PSCCB的无病生存期（DFS）比TN-IDC更差（P = 0.007）。多因素分析显示，EGFR和CK5/6的联合过表达是PSCCB患者OS的唯一独立预后因素（风险比6.08，95%可信区间1.33 - 27.85，P = 0.020），并与淋巴转移（P = 0.023）和p53表达（P = 0.013）相关。其他提示OS和DFS较差的预测因素是淋巴转移和III期，多因素分析后未显示出显著性。此外，已确定铂类化疗可改善EGFR + CK5/6+的PSCCB患者的OS（P = 0.027）。PSCCB的预后比TN-IDC更差。作为PSCCB的唯一独立预后因素，EGFR和CK5/6的联合过表达可能是使用铂类化疗的一个潜在指标。
