Damodaran Dileep, Naidu Bhupathi K, Varghese Jenimol C, Rajan P, Kuruvilla Rojan, Kuruvilla Shalini, Kavitha K P
Department of Surgical Oncology, MVR Cancer Centre And Research Institute, Vellassery, Near Nit Campus, Kozhikode, Kerala 673601 India.
Department of General Surgery, Malabar Institute of Medical Sciences, Calicut,, Kerala India.
Indian J Surg Oncol. 2020 Sep;11(3):446-450. doi: 10.1007/s13193-020-01146-y. Epub 2020 Jun 25.
A prospective study on the level of concordance between core needle biopsy specimen (CNB) and surgical specimen (SS) assesses the oestrogen receptor (ER), progesterone receptor (PR) and Her2/Neu receptor status in Carcinoma breast and its implications on treatment decisions. Ninety consecutive treatment naive operable breast cancer patients treated between September 2015 and April 2017 were included in our prospective study. All patients underwent core needle biopsy prior to definitive surgery. Immunohistochemistry (IHC) studies for ER, PR, and Her2/Neu receptor assay were done in both the CNB specimen and SS. The concordances between CNB specimen and SS for ER, PR, and Her2/Neu receptor were 92%, 88%, and 78% respectively. In our study, overall discordance for ER, PR, and Her2/Neu status based on IHC tests on CNB specimen and its corresponding SS was 41% (37 out of total 90 patients), which was mostly for Her2/Neu (20 patients). Altogether, there was a change in treatment decision based on IHC test results of CNB specimen for 14 out of 37 discordant tests, translating to 15% of the overall study group. Four patients received adjuvant hormonal therapy, and 10 patients got adjuvant Traztuzumab added to their protocol. There is almost perfect to substantial concordance between CNB specimen and SS of IHC tests for ER and PR status. However, the concordance for Her2/Neu receptor is only moderate. Her2/Neu receptor assay by IHC is more sensitive in CNB specimen than in SS.
一项关于粗针活检标本（CNB）与手术标本（SS）之间一致性水平的前瞻性研究，评估了乳腺癌中雌激素受体（ER）、孕激素受体（PR）和Her2/Neu受体状态及其对治疗决策的影响。我们的前瞻性研究纳入了2015年9月至2017年4月期间连续治疗的90例初治可手术乳腺癌患者。所有患者在确定性手术前均接受了粗针活检。对CNB标本和SS均进行了ER、PR免疫组织化学（IHC）研究以及Her2/Neu受体检测。CNB标本与SS在ER、PR和Her2/Neu受体方面的一致性分别为92%、88%和78%。在我们的研究中，基于CNB标本及其相应SS的IHC检测，ER / PR和Her2 / Neu状态的总体不一致率为41%（90例患者中的37例），其中大多是Her2 / Neu（20例患者）。在37例不一致检测中，共有14例基于CNB标本的IHC检测结果改变了治疗决策，占整个研究组的15%。4例患者接受了辅助激素治疗，10例患者在治疗方案中添加了辅助曲妥珠单抗。CNB标本与SS在ER和PR状态的IHC检测方面几乎完全一致或高度一致。然而，Her2 / Neu受体的一致性仅为中等。通过IHC检测Her2 / Neu受体在CNB标本中比在SS中更敏感。
