Saeedi Saedi Hamid, Ghavam Nasiri Mohammad-Reza, ShahidSales Soodabeh, Taghizadeh Ali, Mohammadian Nama
Dept. of Radiation Oncology, Cancer Research Center, Gilan University of Medical Sciences, Rasht, Iran.
Dept. of Radiation Oncology, Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Cancer Prev. 2012 Spring;5(2):69-73.
Systematic treatments such as hormone and chemotherapy are selected according to tumor characteristic after major therapeutic approaches such as surgery. This study attempted to analyze and compare the status of Estrogen Receptor (ER) and Progesterone Receptor (PR) in primary and recurrent sites of breast cancer in patients.
We reviewed all medical records of breast cancer women who were treated between January 1995 and December 2008. One hundred eighty two out of 2241 patients (8.12%) had a metastatic breast cancer. Amongst them 48 patients had tumor and biopsy-driven samples, however 13 samples were destroyed and only 35 samples were investigated in this study, therefore 35 malignant biopsy specimens of breast cancer patients were examined by immunohistochemistry essay for ER and PR. Binominal proportional test and Chi square test were conducted to determine the significant correlation between positive cases of hormone receptors among primary and metastases sites.
Hormone Receptor in the primary tumor (HR1) of 9 patients (25.7%) was positive (ER1 and/or PR1) and in the recurrent areas (HR2) of 8 patients (22.9%) was positive (either ER2 or PR2 positive). Kappa coefficients of diagnostic agreement in primary and recurrent cases were 0.077 and 0.125 for estrogen and progesterone, respectively which indicated that the amount of coefficient of agreement is not considerable between primary and recurrent sites.
The current study indicated that receptor status in recurrent tumors did not pose predictable value based on the analysis of hormone receptors in primary stage, so it is not an appropriate basis to set up therapeutic protocol in the metastatic patients. Therefore, tissue sampling and hormone receptor re-analyzing of metastatic sites should be considered in these cases.
在手术等主要治疗方法之后，会根据肿瘤特征选择激素和化疗等系统治疗方法。本研究试图分析和比较乳腺癌患者原发部位和复发部位雌激素受体（ER）和孕激素受体（PR）的状态。
我们回顾了1995年1月至2008年12月期间接受治疗的乳腺癌女性的所有病历。2241例患者中有182例（8.12%）患有转移性乳腺癌。其中48例患者有肿瘤和活检驱动的样本，但13个样本被销毁，本研究仅调查了35个样本，因此对35例乳腺癌患者的恶性活检标本进行了ER和PR的免疫组织化学检测。采用二项比例检验和卡方检验来确定原发部位和转移部位激素受体阳性病例之间的显著相关性。
9例患者（25.7%）的原发肿瘤（HR1）中的激素受体呈阳性（ER1和/或PR1），8例患者（22.9%）的复发区域（HR2）中的激素受体呈阳性（ER2或PR2阳性）。原发和复发病例中雌激素和孕激素诊断一致性的kappa系数分别为0.077和0.125，这表明原发部位和复发部位之间的一致性系数值不高。
本研究表明，根据原发阶段激素受体的分析，复发肿瘤中的受体状态没有可预测价值，因此它不是为转移性患者制定治疗方案的合适依据。因此，在这些病例中应考虑对转移部位进行组织取样和激素受体重新分析。
