Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China.
Clin Transl Oncol. 2020 Apr;22(4):474-485. doi: 10.1007/s12094-019-02149-0. Epub 2019 Jun 20.
The prognostic and clinical significance of single hormone receptor expression in breast cancer has not been clearly established. The goal of this study was to conduct a meta-analysis to compare the clinical outcomes of patients with ER+PR- tumours and ER-PR+ tumours to those of patients with ER+PR+ tumours.
A systematic review of the literature was conducted to identify studies that compared the clinical outcome of patients with ER+PR- tumours or ER-PR+ tumours with those of patients with ER+PR+ tumours. A total of 18 studies met the inclusion criteria and included 217,485 women. Standard methods for meta-analysis were used, including fixed-effect models.
Patients with ER+PR- tumours or ER-PR+ tumours had significantly worse DFS (HR 1.60, 95% CI 1.44-1.77 and HR 2.27, 95% CI 1.67-3.09), BCSS (HR 1.43, 95% CI 1.33-1.53 and HR 1.82, 95% CI 1.68-1.98) and OS (HR 1.38, 95% CI 1.28-1.47 and HR 1.48, 95% CI 1.17-1.89) than those of patients with ER+PR+ tumours. In subgroup analyses, patients who had ER+PR- tumours experienced a higher risk of recurrence than patients with ER+PR+ tumours in the HER2- (HR 1.57, 95% CI 1.32-1.87), LN - (HR 2.07, 95% CI 1.44-2.86) and endocrine therapy (HR 1.65, 95% CI 1.45-1.89) subgroup. Patients who had HER2- and ER-PR+ tumours had an increased risk of recurrence compared with patients who had HER2- and ER+PR+ tumours (HR 3.10, 95% CI 1.92-5.10).
Among patients with hormone receptor-positive breast cancer, patients with either ER+PR- tumours or ER-PR+ tumours have a higher risk of recurrence and a shorter survival time than those with ER+PR+ tumours. Patients with both types of breast cancer need additional or better treatments.
单一激素受体表达在乳腺癌中的预后和临床意义尚未明确。本研究旨在进行荟萃分析，比较 ER+PR-肿瘤和 ER-PR+肿瘤患者与 ER+PR+肿瘤患者的临床结局。
系统检索文献以确定比较 ER+PR-肿瘤或 ER-PR+肿瘤患者与 ER+PR+肿瘤患者临床结局的研究。共有 18 项研究符合纳入标准，纳入了 217485 名女性。采用固定效应模型等荟萃分析标准方法。
与 ER+PR+肿瘤患者相比，ER+PR-肿瘤或 ER-PR+肿瘤患者的 DFS（HR 1.60，95%CI 1.44-1.77 和 HR 2.27，95%CI 1.67-3.09）、BCSS（HR 1.43，95%CI 1.33-1.53 和 HR 1.82，95%CI 1.68-1.98）和 OS（HR 1.38，95%CI 1.28-1.47 和 HR 1.48，95%CI 1.17-1.89）明显更差。亚组分析显示，在 HER2-（HR 1.57，95%CI 1.32-1.87）、LN-（HR 2.07，95%CI 1.44-2.86）和内分泌治疗（HR 1.65，95%CI 1.45-1.89）亚组中，ER+PR-肿瘤患者的复发风险高于 ER+PR+肿瘤患者。与 HER2-和 ER+PR+肿瘤患者相比，HER2-和 ER-PR+肿瘤患者的复发风险增加（HR 3.10，95%CI 1.92-5.10）。
在激素受体阳性乳腺癌患者中，与 ER+PR+肿瘤患者相比，ER+PR-肿瘤或 ER-PR+肿瘤患者的复发风险更高，生存时间更短。这两种类型的乳腺癌患者需要额外或更好的治疗。
