Department of Radiation Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88, Hangzhou, 310009, People's Republic of China.
Department of Pathology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, 312000, People's Republic of China.
BMC Cancer. 2018 Dec 27;18(1):1290. doi: 10.1186/s12885-018-5217-5.
Estrogen receptor (ER) expression is important for treatment selection and prognostication of breast cancer patients. Although the metastases are the main targets of endocrine therapy, ER status is often based on the primary tumor. However, ER expression in breast cancer primary lesion may not match with its synchronous metastatic lesions in some cases. In this study, we analyzed ER expression concordance between breast cancer primary tumor and metastatic lesions.
Paraffin blocks of 100 primary breast invasive ductal carcinoma cases with axillary lymph node metastases were collected. Five tissue cores were punched out from individual primary breast cancer, and one tissue core from each lymph node metastases to assemble tissue microarrays for ER staining. Samples were then scored as 0, 1+, 2+, and 3+ according to the number and intensity of ER stained tumor cells.
For cases with ER 3+ (strong expression) in all cores of primary lesions (n = 38), ER expression in metastatic lymph node was found in 94.7% of the patients. 91.0% of the metastatic lymph nodes were ER positive, and 84.3% of them to be 3+. Among the 46 cases of ER negative expression in all cores of primary lesions, 39 of them had all the metastatic nodes being ER negative, and ER negative nodes were seen in 95.7% of the metastases. As for 16 cases of ER inconsistent expression in primary lesions, 4 cases showed negative ER expression in all metastatic nodes, 2 cases displayed diffuse consistent ER 3+ expression, and 10 cases displayed variant ER expression.
The findings suggest that ER expression concordance between breast cancer primary lesion and its matched metastatic lesions could be estimated by primary tumor ER expression pattern.
雌激素受体（ER）的表达对乳腺癌患者的治疗选择和预后判断很重要。虽然转移灶是内分泌治疗的主要靶点，但ER 状态通常基于原发肿瘤。然而，在某些情况下，乳腺癌原发灶的 ER 表达与其同步转移灶并不匹配。在这项研究中，我们分析了乳腺癌原发灶与转移灶之间 ER 表达的一致性。
收集了 100 例腋窝淋巴结转移的乳腺浸润性导管癌原发灶的石蜡块。从每个原发乳腺癌中取出 5 个组织芯，从每个淋巴结转移灶中取出 1 个组织芯，以组装组织微阵列进行 ER 染色。根据 ER 染色肿瘤细胞的数量和强度，将样本评分 0、1+、2+和 3+。
对于所有原发灶核心 ER 均为 3+（强表达）的病例（n=38），在 94.7%的患者中发现转移性淋巴结的 ER 表达。91.0%的转移性淋巴结呈 ER 阳性，其中 84.3%为 3+。在所有原发灶核心 ER 均为阴性的 46 例病例中，39 例所有转移淋巴结均为 ER 阴性，95.7%的转移淋巴结为 ER 阴性。对于 16 例原发灶 ER 表达不一致的病例，4 例所有转移性淋巴结均为 ER 阴性表达，2 例显示弥漫性一致的 ER 3+表达，10 例显示变异型 ER 表达。
研究结果表明，可根据原发肿瘤 ER 表达模式来估计乳腺癌原发灶与其匹配转移灶之间的 ER 表达一致性。
