Division of Molecular Diagnostic Pathology, Department of Pathology, Shiga University of Medical Science, Otsu, Japan.
Division of Digestive, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Pathobiology. 2019;86(2-3):92-101. doi: 10.1159/000492833. Epub 2018 Oct 17.
Ductal carcinoma in situ (DCIS) of the breast is heterogeneous in terms of the risk of progression to invasive ductal carcinoma (IDC). To treat DCIS appropriately for its progression risk, we classified individual DCIS by its profile of genomic changes into 2 groups and correlated them with clinicopathological progression factors.
We used surgically resected, formalin-fixed, paraffin-embedded tissues of 22 DCIS and 30 IDC lesions. We performed immunohistochemical intrinsic subtyping, array-based comparative genomic hybridization, and unsupervised clustering.
The samples were divided into 2 major clusters, A and B. Cluster A showed a greater number of gene and chromosome copy number alterations, a larger IDC/DCIS ratio, a higher frequency of nonluminal subtype, a lower frequency of luminal subtype, and a higher nuclear grade, when compared with cluster B. However, there was no difference in the frequencies of lymph node metastasis between clusters A and B. We identified 9 breast-cancer-related genes, including TP53 and GATA3, that highly contributed to the discrimination of A and B clusters.
Classification of breast tumors into rapidly progressive cluster A and the other (cluster B) may contribute to select the treatment appropriate for their progression risk.
乳腺导管原位癌(DCIS)在进展为浸润性导管癌(IDC)的风险方面存在异质性。为了根据进展风险对 DCIS 进行适当治疗,我们根据基因组变化特征将个体 DCIS 分类为 2 组,并将其与临床病理进展因素相关联。
我们使用了 22 例 DCIS 和 30 例 IDC 病变的手术切除、福尔马林固定、石蜡包埋组织。我们进行了免疫组织化学内在分型、基于阵列的比较基因组杂交和无监督聚类。
样本被分为 2 个主要簇,A 和 B。与簇 B 相比,簇 A 显示出更多的基因和染色体拷贝数改变、更大的 IDC/DCIS 比值、更高的非腔型亚型频率、更低的腔型亚型频率和更高的核级。然而,簇 A 和 B 之间的淋巴结转移频率没有差异。我们鉴定了 9 个与乳腺癌相关的基因,包括 TP53 和 GATA3,它们对 A 和 B 簇的区分有很大贡献。
将乳腺肿瘤分为快速进展的 A 簇和其他(B 簇)可能有助于选择适合其进展风险的治疗方法。