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单一孕激素受体阳性的预后意义:雌激素受体阴性/孕激素受体阳性/人表皮生长因子受体2阴性原发性乳腺癌与三阴性乳腺癌的比较研究

Prognostic Significance of Single Progesterone Receptor Positivity: A Comparison Study of Estrogen Receptor Negative/Progesterone Receptor Positive/Her2 Negative Primary Breast Cancer With Triple Negative Breast Cancer.

作者信息

Fan Ying, Ding Xiaoyan, Xu Binghe, Ma Fei, Yuan Peng, Wang Jiayu, Zhang Pin, Li Qing, Luo Yang

机构信息

From the Department of Medical Oncology, Cancer Hospital& Institute, Chinese Academy of Medical Sciences and Peking Union Medical College (YF, BX, FM, PY, JW, PZ, QL, YL); and Department of Oncology, Beijing DiTan Hospital, Capital Medical University, Beijing, P.R. China (XD).

出版信息

Medicine (Baltimore). 2015 Nov;94(46):e2066. doi: 10.1097/MD.0000000000002066.

Abstract

Single progesterone receptor positive (PgR+), especially in form of ER-/PgR+/HER2-, is a nonnegligible phenomenon. Little is known about the characteristics and the role of single PgR positive in this phenotype. Therefore, we explore the significance of single PgR positivity by comparing ER-/PgR+/HER2- breast cancers with triple negative breast cancers (TNBCs).Three thousand nine hundred sixty-six cases of primary invasive breast carcinoma operated consecutively from January 2005 to May 2008 in Cancer Hospital, Chinese Academy of Medical Sciences were examined. Two hundred forty (6%) cases were identified as ER-/PgR+/HER2- breast cancers and 348 (8.8%) cases as TNBCs. Clinicopathological characteristics and survivals were analyzed respectively and then compared between 2 subtypes.Compared with patients with TNBCs, ER-/PgR+/HER2- tumor tended to have lower tumor grade (Grade 3: 45.7% vs. 37.5%, P = 0.051) and smaller tumor size (P = 0.036). However, no differences were found between ER-/PgR+/HER2- and TNBC patients in relapse-free survival (RFS) and OS. The 5-year RFS rates were 80.7% and 77.4%, respectively (P = 0.330) and the 5-year OS rates were 88.0% and 85.2%, respectively (P = 0.290). ER-/PgR+/HER2- patients receiving adjuvant endocrine treatment had better RFS (P = 0.016) and overall survival (OS) (P < 0.0001) than patients receiving no endocrine therapy.This exclusive analysis of patients with ER-/PgR+/HER2- breast cancers showed that this subtype exhibited an aggressive behavior as TNBC, suggesting that it should also be regarded as biologically distinctive group and single PgR positive itself is not a good prognostic factor. However, adjuvant endocrine therapy could still benefit this group of patients. Further investigations should be done to elucidate the underlying mechanism.

摘要

单纯孕激素受体阳性(PgR+),尤其是雌激素受体阴性/孕激素受体阳性/人表皮生长因子受体2阴性(ER-/PgR+/HER2-)这种形式,是一个不可忽视的现象。关于单纯PgR阳性在该表型中的特征及作用,人们了解甚少。因此,我们通过比较ER-/PgR+/HER2-乳腺癌与三阴性乳腺癌(TNBC)来探究单纯PgR阳性的意义。

对2005年1月至2008年5月在中国医学科学院肿瘤医院连续接受手术治疗的3966例原发性浸润性乳腺癌病例进行了检查。其中240例(6%)被确定为ER-/PgR+/HER2-乳腺癌,348例(8.8%)为TNBC。分别分析了临床病理特征及生存情况,然后对这两种亚型进行比较。

与TNBC患者相比,ER-/PgR+/HER2-肿瘤往往具有更低的肿瘤分级(3级:45.7%对37.5%,P = 0.051)和更小的肿瘤大小(P = 0.036)。然而,ER-/PgR+/HER2-患者与TNBC患者在无病生存期(RFS)和总生存期(OS)方面未发现差异。5年RFS率分别为80.7%和77.4%(P = 0.330),5年OS率分别为88.0%和85.2%(P = 0.290)。接受辅助内分泌治疗的ER-/PgR+/HER2-患者比未接受内分泌治疗的患者具有更好的RFS(P = 0.016)和总生存期(OS)(P < 0.0001)。

对ER-/PgR+/HER2-乳腺癌患者的这一专门分析表明,该亚型表现出与TNBC一样的侵袭性行为,这表明它也应被视为生物学上独特的群体,单纯PgR阳性本身并非良好的预后因素。然而,辅助内分泌治疗仍可使该组患者获益。应进一步开展研究以阐明其潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d251/4652828/37e323f6c244/medi-94-e2066-g001.jpg

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