Widodo Irianiwati, Dwianingsih Ery Kus, Triningsih Ediati, Utoro Totok
Department of Anatomical Pathology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia E-mail :
Asian Pac J Cancer Prev. 2014;15(15):6109-13. doi: 10.7314/apjcp.2014.15.15.6109.
Breast cancer is a heterogeneous disease with molecular subtypes that have biological distinctness and different behavior. They are classified into luminal A, luminal B, Her-2 and triple negative/basal-like molecular subtypes. Most of breast cancers reported in Indonesia are already large size, with high grade or late stage but the clinicopathological features of different molecular subtypes are still unclear. They need to be better clarified to determine proper treatment and prognosis.
To elaborate the clinicopathological features of molecular subtypes of breast cancers in Indonesian women.
A retrospective cross-sectional study of 84 paraffin-embedded tissues of breast cancer samples from Dr. Sardjito General Hospital in Central Java, Indonesia was performed. Expression of ER, PR, Her-2 and Ki-67 was analyzed to classify molecular subtypes of breast cancer by immunohistochemistry. The relation of clinicopathological features of breast cancers with molecular subtypes of luminal A, luminal B, Her-2 and triple negative/basal-like were analyzed using Pearson's Chi-Square test. A p-value of <0.05 was considered statistically significant.
Case frequency of luminal A, Luminal B, Her-2+ and triple negative/basal-like subtypes were 38.1%, 16.7%, 20.2% and 25%, respectively. Significant difference was found in breast cancer molecular subtypes in regard to age, histological grade, lymph node status and staging. However it showed insignificant result in regard to tumor size. Luminal A subtype of breast cancer was commonly found in >50 years old women (p:0.028), low grade cancer (p:0.09), negative lymph node metastasis (p:0.034) and stage III (p:0.017). Eventhough the difference was insignificant, luminal A subtype breast cancer was mostly found in small size breast cancer (p:0.129). Her-2+ subtype breast cancer was more commonly diagnosed with large size, positive lymph node metastasis and poor grade. Triple negative/basal-like cancer was mostly diagnosed among <50 years old women.
This study suggests that immunohistochemistry-based subtyping is essential to classify breast carcinoma into subtypes that vary in clinicopathological features, implying different therapeutic options and prognosis for each subtype.
乳腺癌是一种异质性疾病，其分子亚型具有生物学上的独特性和不同行为。它们被分为腔面A型、腔面B型、人表皮生长因子受体2（Her-2）型和三阴性/基底样分子亚型。印度尼西亚报告的大多数乳腺癌已经是大尺寸、高级别或晚期，但不同分子亚型的临床病理特征仍不清楚。需要对其进行更深入的阐明，以确定合适的治疗方法和预后。
阐述印度尼西亚女性乳腺癌分子亚型的临床病理特征。
对印度尼西亚中爪哇省萨迪托综合医院84例乳腺癌样本石蜡包埋组织进行回顾性横断面研究。通过免疫组织化学分析雌激素受体（ER）、孕激素受体（PR）、Her-2和Ki-67的表达，以对乳腺癌分子亚型进行分类。使用Pearson卡方检验分析乳腺癌临床病理特征与腔面A型、腔面B型、Her-2型和三阴性/基底样分子亚型之间的关系。p值<0.05被认为具有统计学意义。
腔面A型、腔面B型、Her-2阳性型和三阴性/基底样亚型的病例频率分别为38.1%、16.7%、20.2%和25%。在乳腺癌分子亚型的年龄、组织学分级、淋巴结状态和分期方面发现了显著差异。然而，在肿瘤大小方面结果不显著。腔面A型乳腺癌常见于年龄>50岁的女性（p:0.028）、低级别癌症（p:0.09）、无淋巴结转移（p:0.034）和III期（p:0.017）。尽管差异不显著，但腔面A型乳腺癌大多见于小尺寸乳腺癌（p:0.129）。Her-2阳性型乳腺癌更常被诊断为大尺寸、有淋巴结转移且分级差。三阴性/基底样癌大多在年龄<50岁的女性中被诊断出来。
本研究表明，基于免疫组织化学的亚型分类对于将乳腺癌分为临床病理特征不同的亚型至关重要，这意味着每种亚型有不同的治疗选择和预后。
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