原发性与转移性乳腺癌之间的肿瘤生物标志物转换:mRNA评估及其与免疫组织化学的一致性

Tumor biomarker conversion between primary and metastatic breast cancer: mRNA assessment and its concordance with immunohistochemistry.

作者信息

Stefanovic Stefan, Wirtz Ralph, Deutsch Thomas M, Hartkopf Andreas, Sinn Peter, Varga Zsuzsanna, Sobottka Bettina, Sotiris Lakis, Taran Florin-Andrei, Domschke Christoph, Hennigs Andre, Brucker Sara Y, Sohn Christof, Schuetz Florian, Schneeweiss Andreas, Wallwiener Markus

机构信息

Department of Gynecology and Obstetrics, Heidelberg University Hospital, 69120 Heidelberg, Germany.

National Center for Tumor Diseases (NCT) Heidelberg, 69120 Heidelberg, Germany.

出版信息

Oncotarget. 2017 May 19;8(31):51416-51428. doi: 10.18632/oncotarget.18006. eCollection 2017 Aug 1.

Abstract

Biomarker changes between primary (PT) and metastatic tumor (MT) site may be significant in individualizing treatment strategies and can result from actual clonal evolution, biomarker conversion, or technical limitations of diagnostic tests. This study explored biomarker conversion during breast cancer (BC) progression in 67 patients with different tumor subtypes and metastatic sites via mRNA quantification and subsequently analyzed the concordance between real-time qPCR and immunohistochemistry (IHC). Immunostaining for estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 was performed on formalin-fixed, paraffin-embedded PT and MT tissue sections. RT-qPCR was performed using a multiplex RT-qPCR kit for , , , and and the reference genes and . Subsequent measurement of tumor biomarker mRNA expression to detect conversion revealed significant decreases in and mRNA and upregulation (all < 0.001) in MT compared to PT of all tumor subtypes and upregulation in MT from triple-negative PT patients ( = 0.023). Furthermore, mRNA was upregulated in MT brain biopsies, particularly those from triple-negative PTs ( = 0.023). High concordance between RT-qPCR and IHC was observed for ER/ (81%(κ 0.51) in PT and 84%(κ 0.34) in MT, PR/ (70%(κ 0.10) in PT and 78% (κ -0.32) in MT), and for HER2/ (100% in PT and 89% in MT). Discordance between mRNA biomarker assessments of PT and MT resulting from receptor conversion calls for dynamic monitoring of BC tumor biomarkers. Overall, RT-qPCR assessment of BC target genes and their mRNA expression is highly concordant with IHC protein analysis in both primary and metastatic tumor.

摘要

原发性肿瘤(PT)和转移瘤(MT)部位之间的生物标志物变化在个体化治疗策略中可能具有重要意义,其可能源于实际的克隆进化、生物标志物转换或诊断测试的技术局限性。本研究通过mRNA定量探索了67例不同肿瘤亚型和转移部位的乳腺癌(BC)患者在疾病进展过程中的生物标志物转换情况,并随后分析了实时定量PCR与免疫组织化学(IHC)之间的一致性。对福尔马林固定、石蜡包埋的PT和MT组织切片进行雌激素受体(ER)、孕激素受体(PR)、HER2和Ki-67的免疫染色。使用针对、、和的多重逆转录定量PCR试剂盒以及参考基因和进行逆转录定量PCR。随后通过测量肿瘤生物标志物mRNA表达以检测转换情况,结果显示,与所有肿瘤亚型的PT相比,MT中的和mRNA显著降低,且上调(均<0.001),三阴性PT患者的MT中上调(=0.023)。此外,MT脑活检组织中,尤其是来自三阴性PT患者的活检组织中,mRNA上调(=0.023)。观察到ER/在RT-qPCR与IHC之间具有高度一致性(PT中为81%(κ 0.51),MT中为84%(κ 0.34)),PR/(PT中为70%(κ 0.10),MT中为78%(κ -0.32)),以及HER2/(PT中为100%,MT中为89%)。由受体转换导致的PT和MT的mRNA生物标志物评估之间的不一致性要求对BC肿瘤生物标志物进行动态监测。总体而言,BC靶基因及其mRNA表达的RT-qPCR评估与原发性和转移性肿瘤中的IHC蛋白质分析高度一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566a/5584258/2f0adbddc81c/oncotarget-08-51416-g001.jpg

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