Reigosa Aldo, Hardisson David, Sanzi Francisco, Caleiras Eduardo, Saldivia Felipe, Fernández Angel
Invest Clin. 2016 Jun;57(2):187-216.
Breast carcinomas have been classified from the molecular point of view into four major groups (Luminal A, Luminal B, HER2 and triple negative). However, these groups are not homogeneous and there is a need to establish subcategories that can be identified by immunohistochemistry (IHC), to better predict prognosis and carry out treatments that are more effective. This study was conducted in 354 patients diagnosed with invasive ductal breast carci- noma. The expression of 22 molecules was analyzed by tissue matrices and the results obtained were compared with molecular classes defined by IHC, according to the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2, and the overall survival. The Luminal A molecular class can set various prognosticosubgroups: the subgroup with exclusive expression of ER and PR, with Ki-67 ≤14%, with a better prognosis, and the subgroup of Luminal A with Ki-67> 14% or other expression related to the basal phenotype markers. Luminal B group can be divided into subtypes according to the expression of Ki-67 (cutoff at 25%). In the HER2 class it seems important the Ki-67 index for forecasting (cutoff at 25%). The TN class can be divided according to the rate of proliferation into two prognostic categories, with a better prog- nosis for tumors with Ki-67 index ≤25%.
从分子角度来看，乳腺癌已被分为四大类（管腔A型、管腔B型、HER2型和三阴性）。然而，这些类别并非同质，需要建立可通过免疫组织化学（IHC）识别的亚类，以便更好地预测预后并开展更有效的治疗。本研究针对354例诊断为浸润性导管癌的患者进行。通过组织基质分析了22种分子的表达情况，并将所得结果与根据雌激素受体（ER）、孕激素受体（PR）和HER2的表达以及总生存期定义的分子类别进行比较。管腔A型分子类别可分为多个预后亚组：ER和PR单独表达、Ki-67≤14%且预后较好的亚组，以及Ki-67>14%或有其他与基底表型标志物相关表达的管腔A型亚组。管腔B组可根据Ki-67的表达（临界值为25%）分为不同亚型。在HER2类别中，Ki-67指数对于预测似乎很重要（临界值为25%）。三阴性类别可根据增殖率分为两个预后类别，Ki-67指数≤25%的肿瘤预后较好。
