转移性乳腺癌患者远处转移病灶 Ki-67 免疫组化表达的临床病理和预后意义。
Clinicopathological and prognostic significance of Ki-67 immunohistochemical expression of distant metastatic lesions in patients with metastatic breast cancer.
机构信息
Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
Department of Pathology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan.
出版信息
Breast Cancer. 2017 Nov;24(6):748-755. doi: 10.1007/s12282-017-0774-z. Epub 2017 Apr 19.
BACKGROUND
Surgical biopsy of metastatic lesions followed by pathological confirmation for the investigation of biomarkers is occasionally proposed as an effective strategy in the treatment of metastatic breast cancer. However, few reports have examined Ki-67 immunohistochemical expression in distant metastatic lesions of breast cancer patients. This study aimed to investigate the clinicopathological significance of subtypes and Ki-67 immunohistochemical expression in metastatic breast cancer lesions.
METHODS
We retrospectively studied surgical specimens of primary breast cancer tumors and their corresponding metastatic lesions from patients (n = 68) who underwent surgery for primary breast cancer tumors between December 1977 and March 2013. Tissue microarrays were constructed using primary and metastatic lesions, and were stained with antibodies against estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67. We also examined the clinicopathological characteristics and outcome measures of patients with metastatic breast cancer using primary and paired metastatic lesions.
RESULTS
Compared with the primary lesions, there was no significant difference in subtypes in the metastatic lesions according to metastatic sites. Metastatic lesions of the brain, viscera, and bone exhibited slightly higher levels of Ki-67 immunohistochemical expression compared with primary lesions. A Cox proportional hazards model using multivariate analysis demonstrated that high Ki-67 immunohistochemical expression in distant metastatic lesions was associated with poorer overall survival outcomes after biopsy of recurrence lesion (hazard ratio 2.307; 95% confidence interval 1.207-4.407, P = 0.011).
CONCLUSIONS
High Ki-67 immunohistochemical expression levels in distant metastatic lesions were independently associated with poorer overall survival outcomes after biopsy of recurrence lesion in breast cancer patients.
背景
对于转移性乳腺癌患者，有时会提议进行转移性病变的外科活检，然后通过病理确认来寻找生物标志物，这是一种有效的策略。然而，很少有报道研究过乳腺癌远处转移性病变中 Ki-67 免疫组织化学表达。本研究旨在探讨转移性乳腺癌病变中亚型和 Ki-67 免疫组织化学表达的临床病理意义。
方法
我们回顾性研究了 1977 年 12 月至 2013 年 3 月期间接受原发性乳腺癌手术的患者（n=68）的原发性乳腺癌肿瘤和相应转移性病变的手术标本。使用原发性和转移性病变构建组织微阵列，并使用针对雌激素受体、孕激素受体、人表皮生长因子受体 2 和 Ki-67 的抗体进行染色。我们还使用原发性和配对转移性病变检查了转移性乳腺癌患者的临床病理特征和预后指标。
结果
与原发性病变相比，转移性病变的亚型根据转移部位没有明显差异。与原发性病变相比，脑、内脏和骨的转移性病变的 Ki-67 免疫组织化学表达水平略高。使用多变量分析的 Cox 比例风险模型表明，远处转移性病变中 Ki-67 免疫组织化学表达较高与活检复发性病变后的总生存结局较差相关（风险比 2.307；95%置信区间 1.207-4.407，P=0.011）。
结论
远处转移性病变中 Ki-67 免疫组织化学表达水平较高与乳腺癌患者活检复发性病变后的总生存结局较差独立相关。
Zotero 插件