Poulakaki Nikiforita, Makris Georgios-Marios, Battista Marco-Johannes, Böhm Daniel, Petraki Kalliopi, Bafaloukos Dimitrios, Sergentanis Theodoros N, Siristatidis Charalampos, Chrelias Charalampos, Papantoniou Nikolaos
General Hospital "Metropolitan", Athens, Greece.
Third Department of Obstetrics and Gynecology, "Attikon Hospital", National University of Athens, Athens, Greece; Department of Gynecology and Obstetrics, University Hospital Mainz, Mainz, Germany.
Breast. 2016 Feb;25:57-61. doi: 10.1016/j.breast.2015.10.007. Epub 2015 Nov 21.
Local recurrence is considered a major concern in patients diagnosed with ductal carcinoma in situ (DCIS), as its invasive occurrence is associated with high rates of distant disease and mortality. This study aims to assess the possible correlation of hormonal receptor status, Ki-67 and HER2 expression with recurrence rates in women with DCIS, taking also into account the potential prognostic effects of grade and age at diagnosis.
230 consecutive patients with DCIS were included in this study. Invasive and non-invasive recurrence events were recorded, as a total. Clinicopathological information, as well as PR positivity, ER positivity, HER2 positivity and ki-67 expression were analyzed. Multivariable Cox regression analysis was performed, examining the risk factors for recurrence.
Recurrence was noted in 17.8% of cases; the median follow-up was 44 months. Higher grade (adjusted HR = 1.72, 95%CI: 1.06-2.78), age at diagnosis (adjusted HR = 0.60, 95%CI: 0.43-0.83), Ki-67 expression (adjusted HR = 1.78, 95%CI: 1.11-2.88), and type of administered treatment were independently associated with increased recurrence rates. Recurrence rates were not significantly associated with ER, PR status or HER2 expression.
In addition to high grade, administered treatment and younger age at diagnosis, high Ki-67 expression seems to be independently associated with increased likelihood of recurrence in patients with DCIS. Future studies with additional molecular markers seem necessary to further improve the identification of high-risk patients for DCIS recurrence.
局部复发被认为是导管原位癌（DCIS）患者的主要问题，因为其侵袭性发生与远处疾病和死亡率的高发生率相关。本研究旨在评估激素受体状态、Ki-67和HER2表达与DCIS女性患者复发率之间的可能相关性，同时考虑诊断时分级和年龄的潜在预后影响。
本研究纳入了230例连续的DCIS患者。总共记录了侵袭性和非侵袭性复发事件。分析了临床病理信息以及PR阳性、ER阳性、HER2阳性和ki-67表达情况。进行多变量Cox回归分析，检查复发的危险因素。
17.8%的病例出现复发；中位随访时间为44个月。分级较高（调整后HR = 1.72，95%CI：1.06 - 2.78）、诊断时年龄（调整后HR = 0.60，95%CI：0.43 - 0.83）、Ki-67表达（调整后HR = 1.78，95%CI：1.11 - 2.88）以及所接受治疗的类型与复发率增加独立相关。复发率与ER、PR状态或HER2表达无显著相关性。
除了分级较高、所接受治疗和诊断时年龄较小外，高Ki-67表达似乎与DCIS患者复发可能性增加独立相关。未来有必要开展更多包含其他分子标志物的研究，以进一步改善DCIS复发高危患者的识别。
