Sleightholm Richard, Neilsen Beth K, Elkhatib Safwan, Flores Laura, Dukkipati Saihari, Zhao Runze, Choudhury Songita, Gardner Bret, Carmichael Joey, Smith Lynette, Bennion Nathan, Wahl Andrew, Baine Michael
Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
These authors contributed equally.
J Clin Med Res. 2021 Jan;13(1):9-19. doi: 10.14740/jocmr4398. Epub 2021 Jan 12.
A majority of breast cancer tumors express estrogen receptor (ER) and/or progesterone receptor (PR); however, the percentage of cancer cells expressing these receptors can range from 0-100%. The prognostic and therapeutic impact of the percentage of cells expressing hormone receptors in breast cancer is not fully understood.
A retrospective analysis of 411 breast cancer patients who were treated at the University of Nebraska Medical Center between 2010 and 2017 was performed. Patient tumors were evaluated for percentage of cells expressing ER and PR in conjunction with clinical outcomes.
Patient tumors demonstrated a highly bimodal pattern of ER and PR staining with a majority of tumors demonstrating either a high percentage (> 80% of cells) or lack of cells (0%) staining for ER or PR. An increase in the percentage of ER positivity correlated with decreased local recurrence and improved overall survival. An increase in the percentage of PR positivity demonstrated a trend towards decreased local recurrence and improved overall survival, but was not statistically significant.
Results based on both continuous and categorical evaluation of ER expression revealed that increasing expression correlated with improved patient outcomes. Similar evaluation of PR expression demonstrated a trend towards improved patient outcomes though not statistically significant. These findings suggest that the degree of hormone receptor positivity and not a Boolean representation of positivity could provide additional prognostic value in the treatment and management of breast cancer.
大多数乳腺癌肿瘤表达雌激素受体（ER）和/或孕激素受体（PR）；然而，表达这些受体的癌细胞百分比范围可为0 - 100%。乳腺癌中表达激素受体的细胞百分比对预后和治疗的影响尚未完全明确。
对2010年至2017年间在内布拉斯加大学医学中心接受治疗的411例乳腺癌患者进行回顾性分析。结合临床结局评估患者肿瘤中表达ER和PR的细胞百分比。
患者肿瘤显示出ER和PR染色的高度双峰模式，大多数肿瘤显示ER或PR染色的细胞百分比高（> 80%的细胞）或无细胞（0%）染色。ER阳性百分比增加与局部复发减少和总生存期改善相关。PR阳性百分比增加显示出局部复发减少和总生存期改善的趋势，但无统计学意义。
基于对ER表达的连续和分类评估的结果显示，表达增加与患者预后改善相关。对PR表达的类似评估显示出患者预后改善的趋势，尽管无统计学意义。这些发现表明，激素受体阳性程度而非阳性的布尔表示形式可能在乳腺癌的治疗和管理中提供额外的预后价值。
