Serra P, Sanz-Santos J, Castellà E, Cirauqui B, Andreo F, Llatjós M, Avila M, Margelí M, Serrano L, Centeno C, Quiroga V, Torky M, Ruiz-Manzano J
Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain.
Department of Medicine, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain.
Cytopathology. 2018 Feb;29(1):35-40. doi: 10.1111/cyt.12486. Epub 2017 Nov 9.
In breast cancer patients, the expression statuses of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are crucial in the choice of treatment. Receptor expression in metastatic lesions can differ from the primary tumour. The aim of our study was to analyse the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to obtain samples allowing the identification of ER, PR and HER2 expression in patients with mediastinal metastases of breast cancer.
The clinical files of all patients with a final diagnosis of breast cancer mediastinal metastases diagnosed by EBUS-TBNA in our institution were retrospectively analysed. The ability of EBUS-TBNA to obtain samples that allowed hormone receptor and HER2 expression analysis was calculated.
Twenty-four patients were included. ER, PR and HER2 assessments could be performed in 22, 20 and 22 patients, respectively. In 20 of the 24 patients it was possible to investigate all three types of receptor expression. In the remaining four cases, where ER, PR or HER2 expression tests could not be performed, it was due to a lack of tissue. In cases with adequate results for EBUS-TBNA and the primary tumour agreement was greater for ER (16/19) and HER2 (12/14) than PR (8/17). Based on receptor status, there was a change in the choice of treatment for five patients.
In patients with breast cancer mediastinal metastases, ER, PR and HER2 expression can be assessed in samples obtained by EBUS-TBNA whenever a sufficient tissue sample is collected.
在乳腺癌患者中,雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)的表达状态对治疗方案的选择至关重要。转移病灶中的受体表达可能与原发肿瘤不同。我们研究的目的是分析经支气管超声引导下经支气管针吸活检(EBUS-TBNA)获取样本以鉴定乳腺癌纵隔转移患者中ER、PR和HER2表达的实用性。
回顾性分析我院所有经EBUS-TBNA最终诊断为乳腺癌纵隔转移患者的临床资料。计算EBUS-TBNA获取允许进行激素受体和HER2表达分析样本的能力。
纳入24例患者。分别有22例、20例和22例患者可进行ER、PR和HER2评估。24例患者中有20例能够检测所有三种受体的表达。在其余4例无法进行ER、PR或HER2表达检测的病例中,原因是缺乏组织。对于EBUS-TBNA结果充分的病例,ER(16/19)和HER2(12/14)的结果与原发肿瘤的一致性高于PR(8/17)。基于受体状态,5例患者的治疗选择发生了改变。
对于乳腺癌纵隔转移患者,只要收集到足够的组织样本,就可以通过EBUS-TBNA获取的样本评估ER、PR和HER2的表达。