Fan Ying, Ding Xiaoyan, Xu Binghe, Ma Fei, Yuan Peng, Wang Jiayu, Zhang Pin, Li Qing, Luo Yang
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).
Medicine (Baltimore). 2015 Nov;94(46):e2066. doi: 10.1097/MD.0000000000002066.
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.
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。