Wang Tong, Ma Yuanyuan, Wang Liang, Liu Hong, Chen Meixuan, Niu Ruifang
National Clinical Research Center for Cancer, The Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.
Tumour Biol. 2015 Aug;36(8):6113-24. doi: 10.1007/s13277-015-3293-6. Epub 2015 Mar 25.
The data on the outcome of breast invasive lobular carcinoma (ILC) are conflicting. In addition, the prognostic effect of molecular subtypes on ILC remains unclear. In this study, the clinicopathological and prognostic data between 269 ILC and 816 invasive ductal carcinoma (IDC) cases in a Chinese population were extensively compared, with a median follow-up time of 7.8 years. Compared with the IDC group, ILC tumors had more lymph node invasion, hormonal receptor positivity, and human epidermal growth factor receptor 2 (HER2) negativity. ILC patients showed overall survival (OS) and recurrence/metastasis-free survival (RFS) rates similar to those of IDC patients but exhibited worse disease-free survival (DFS) rate because of the higher rate of contralateral breast cancer (BC). Further analysis showed that OS, RFS, and DFS were similar between ILC and IDC patients in the subgroups of luminal A and triple-negative BC with HER2 negativity but were worse in ILC patients than those in IDC patients in the subgroups of luminal B and HER2 overexpression with positive HER2 expression. Multivariate analysis indicated HER2 positivity as an independent risk factor for OS, RFS, and DFS of ILC patients, which increased the risk in the ILC group than that in IDC group. The interaction of HER2 and ILC was also defined as an independent risk factor for OS, RFS, and DFS of the entire population. In conclusion, overexpression of HER2 exhibited stronger negative effect on the prognosis of ILC patients than that in IDC patients, suggesting that treatment targeting HER2 is crucial for this BC subgroup.
关于乳腺浸润性小叶癌（ILC）的预后数据存在矛盾。此外，分子亚型对ILC的预后影响仍不明确。在本研究中，广泛比较了中国人群中269例ILC和816例浸润性导管癌（IDC）患者的临床病理和预后数据，中位随访时间为7.8年。与IDC组相比，ILC肿瘤有更多的淋巴结侵犯、激素受体阳性和人表皮生长因子受体2（HER2）阴性。ILC患者的总生存期（OS）和无复发/转移生存期（RFS）与IDC患者相似，但无病生存期（DFS）较差，因为对侧乳腺癌（BC）发生率较高。进一步分析显示，在激素受体A亚型和HER2阴性的三阴性乳腺癌亚组中，ILC和IDC患者的OS、RFS和DFS相似，但在激素受体B亚型和HER2过表达且HER2阳性的亚组中，ILC患者的这些指标比IDC患者差。多因素分析表明，HER2阳性是ILC患者OS、RFS和DFS的独立危险因素，与IDC组相比，ILC组的风险增加。HER2与ILC的相互作用也被定义为整个人群OS、RFS和DFS的独立危险因素。总之，HER2过表达对ILC患者预后的负面影响比IDC患者更强，这表明针对HER2的治疗对该BC亚组至关重要。
