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雄激素受体、CK-5/6、KI-67及分子亚型在乳腺癌中的临床意义

Cinical Significance of Androgen Receptor, CK-5/6, KI-67 and Molecular Subtypes in Breast Cancer.

作者信息

Kayahan Münire, İdiz Ufuk Oğuz, Gucin Zuhal, Erözgen Fazilet, Memmi Naim, Müslümanoğlu Mahmut

机构信息

Department of General Surgery, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey.

Department of Pathology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey.

出版信息

J Breast Health. 2014 Oct 1;10(4):201-208. doi: 10.5152/tjbh.2014.1777. eCollection 2014 Oct.

Abstract

OBJECTIVE

To detect the relationship between molecular subtypes of breast cancer with expressions of androgen receptor, cytokeratin 5/6 (CK5/6)and Ki-67.

MATERIALS AND METHODS

Expressions of androgen receptor, CK-5/6 and Ki-67 were determined by immunohistochemistry in paraffin-embedded sections obtained from 86 invasive breast cancer cases of stages I/IIa/IIb in 4 molecular subtypes. Patients treated for recurrent disease and locally advanced disease were excluded.

RESULTS

Forty one luminal A cases, ie. positive estrogen receptor(ER) and/or progesteron receptor (PR) with negative epidermal growth factor receptor (HER2), 14 luminal B, ie. positive ER and/or PR and positive HER2, 14 HER2-enriched (HER2+), ie. negative ER and PR with positive HER2, and 17 triple negative (negative ER and PR and HER2) invasive breast cancers were included. Mean follow-up was 17.46±11.70 mo. Androgen receptor-negativity and CK5/6-positivity were significantly more common in HER2+ and triple negative groups. Ki-67 and histological grade were higher in HER2+ group, significantly. Two deaths were triple negative (P=0.04). Androgen receptor-negativity, CK5/6 and Ki-67 status did not affect survival or systemic metastases, significantly. All groups had local recurrences. Local recurrence was significantly associated with androgen receptor-negativity in luminal A and high Ki-67 value in HER2+ groups. Systemic metastases were significantly more common in triple negative and HER2+ groups.

CONCLUSION

Molecular subtypes of breast cancer are prognostic and predictive. Androgen receptor is expressed more commonly in luminal subtypes with better prognosis and androgen receptor negativity is associated with development of local recurrence in luminal A cancers.

摘要

目的

检测乳腺癌分子亚型与雄激素受体、细胞角蛋白5/6(CK5/6)和Ki-67表达之间的关系。

材料与方法

采用免疫组织化学法检测86例I/IIa/IIb期4种分子亚型浸润性乳腺癌石蜡包埋切片中雄激素受体、CK-5/6和Ki-67的表达。排除复发性疾病和局部晚期疾病患者。

结果

纳入41例腔面A型病例,即雌激素受体(ER)和/或孕激素受体(PR)阳性且表皮生长因子受体(HER2)阴性;14例腔面B型病例,即ER和/或PR阳性且HER2阳性;14例HER2富集型(HER2+)病例,即ER和PR阴性且HER2阳性;17例三阴性(ER、PR和HER2均阴性)浸润性乳腺癌病例。平均随访时间为17.46±11.70个月。HER2+组和三阴性组中雄激素受体阴性和CK5/6阳性更为常见。HER2+组的Ki-67和组织学分级显著更高。有2例死亡病例为三阴性(P=0.04)。雄激素受体阴性、CK5/6和Ki-67状态对生存或全身转移无显著影响。所有组均有局部复发。腔面A型中局部复发与雄激素受体阴性显著相关,HER2+组中局部复发与高Ki-67值显著相关。全身转移在三阴性组和HER2+组中更为常见。

结论

乳腺癌分子亚型具有预后和预测价值。雄激素受体在预后较好的腔面亚型中更常见,腔面A型乳腺癌中雄激素受体阴性与局部复发的发生有关。

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Expression of androgen receptors in primary breast cancer.雄激素受体在原发性乳腺癌中的表达。
Ann Oncol. 2010 Mar;21(3):488-492. doi: 10.1093/annonc/mdp510. Epub 2009 Nov 3.

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