男性乳腺癌的免疫表型分析——一家三级医疗中心的经验

Immunophenotyping of male breast cancer - Experience at a tertiary care centre.

作者信息

Pasricha Sunil, Kamboj Meenakshi, Tanwar Parul, Gupta Gurudutt, Panigrahi Manoj, Sharma Anila, Durga Garima, Mehta Anurag

机构信息

Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.

出版信息

Indian J Pathol Microbiol. 2019 Apr-Jun;62(2):226-231. doi: 10.4103/IJPM.IJPM_543_18.

DOI:10.4103/IJPM.IJPM_543_18

PMID:30971545

Abstract

BACKGROUND

Male breast cancers (MBCs) are uncommon and account for 1% of all breast cancers. Medical conditions that increase the estrogen to testosterone ratio are implicated as the risk factors. Morphologically similar, but MBCs have biological differences compared with female breast cancer (FBC).

PURPOSE

The present study was aimed to examine the immunophenotype of MBC, subsequent molecular subtypes, their association with clinicopathological features, and prognosis.

MATERIALS AND METHODS

We analyzed clinicopathological features of 42 cases of MBC, and classified them according to molecular classification using immunohistochemistry (IHC). This is the second largest study from India.

RESULTS AND CONCLUSION

Median age of patients was 61 years (age range: 41-87 years). Invasive duct carcinoma comprised 95.2% of cases. Tumor grade II and III was seen in 50% and 47.6% of cases, respectively, and advanced stage disease (III/IV) was seen in 45.2% cases (n = 39). Estrogen receptor (ER) was positive in 97.6% cases, progesterone receptor (PR) in 83.3%, androgen receptor (AR) in 76.2%, HER2 in 4.8%, Cyclin-D1 in 92.9%, Bcl2 in 66.7%, GCDFP-15 in 23.8%, p53 in 16.7%, and Ki67 index was low (<14%) in 66.7% cases. Molecular subtyping of these cases revealed 64.3% of luminal A, 35.7% of luminal B, and no HER2 rich/driven category or triple negative case. There was no statistical significance between luminal A and B category pertaining to overall stage of tumor (P = 0.905). Lymph node metastasis was more commonly associated with luminal B category (P = 0.089). p53 positivity showed significant association with luminal A cases (P = 0.002) and nodal metastasis (P = 0.042). GCDFP-15 positivity showed significant association with higher tumor grade (P = 0.042) and stage (P = 0.047). Stage was the most significant prognostic marker (P < 0.0001). On follow-up (n = 27), all the six cases that showed recurrence/persistent disease were high stage (III/IV) on presentation.

摘要

背景

男性乳腺癌（MBC）并不常见，占所有乳腺癌的1%。雌激素与睾酮比值升高的医学状况被认为是风险因素。MBC在形态上与女性乳腺癌（FBC）相似，但存在生物学差异。

目的

本研究旨在检测MBC的免疫表型、后续分子亚型、它们与临床病理特征的关联以及预后。

材料与方法

我们分析了42例MBC的临床病理特征，并使用免疫组织化学（IHC）根据分子分类对其进行分类。这是来自印度的第二大研究。

结果与结论

患者的中位年龄为61岁（年龄范围：41 - 87岁）。浸润性导管癌占病例的95.2%。肿瘤II级和III级分别见于50%和47.6%的病例，晚期疾病（III/IV期）见于45.2%的病例（n = 39）。雌激素受体（ER）在97.6%的病例中呈阳性，孕激素受体（PR）在83.3%，雄激素受体（AR）在76.2%，HER2在4.8%，细胞周期蛋白D1在92.9%，Bcl2在66.7%，GCDFP - 15在23.8%，p53在16.7%，且66.7%的病例中Ki67指数较低（<14%）。这些病例的分子亚型显示，腔面A型占64.3%，腔面B型占35.7%，没有HER2富集/驱动型或三阴性病例。腔面A型和B型在肿瘤总体分期方面无统计学意义（P = 0.905）。淋巴结转移更常见于腔面B型（P = 0.089）。p53阳性与腔面A型病例（P = 0.002）和淋巴结转移（P = 0.042）显著相关。GCDFP - 15阳性与较高的肿瘤分级（P = 0.042）和分期（P = 0.047）显著相关。分期是最显著的预后标志物（P < 0.0001）。在随访（n = 27）中，所有6例出现复发/持续性疾病的病例在初诊时均为高分期（III/IV期）。