Suppr超能文献

三阴性乳腺小叶癌:具有特定 ESRRA 突变的腔面雄激素受体癌。

Triple-negative breast lobular carcinoma: a luminal androgen receptor carcinoma with specific ESRRA mutations.

机构信息

Unit of Pathology, Department of Biology and Pathology of the Tumors, Centre Georges-François Leclerc, Dijon, France.

Department of Biopathology, Institut Bergonié, Bordeaux, France.

出版信息

Mod Pathol. 2021 Jul;34(7):1282-1296. doi: 10.1038/s41379-021-00742-9. Epub 2021 Mar 22.

Abstract

Primary triple-negative invasive lobular breast carcinomas (TN-ILCs), which do not express hormone receptors and HER2 at diagnosis, are rare and poorly known. In this study, we analyzed the largest TN-ILC series ever reported in the literature, in comparison to phenotypically similar breast tumor subtypes: triple-negative invasive ductal carcinoma (TN-IDC) and hormone receptor-positive invasive lobular carcinoma (HR + ILC). All primary TN-ILCs registered in our database between 2000 and 2018 (n = 38) were compared to tumors from control groups, matched by stage and Elston/Ellis grade, with regard to clinical, pathologic, and immunohistochemical characteristics. A comparative molecular analysis (whole-exome and RNA sequencing using next-generation technology) was also performed. We found that TN-ILC patients were older than those with HR + ILC (P = 0.002) or TN-IDC (P < 0.001). Morphologically, TN-ILCs had aggressive phenotypes, with more pleomorphism (P = 0.003) and higher nuclear grades than HR + ILCs (P = 0.009). Immunohistochemistry showed that TN-ILCs less frequently expressed basal markers (CK5/6, EGFR and SOX10) than TN-IDCs (P < 0.001), while androgen receptor (AR) positivity was more prevalent (P < 0.001). Survival curves analysis did not show differences between TN-ILC and TN-IDC patients, while overall and distant metastasis-free survival were significantly worse compared to those with HR + ILCs (P = 0.047 and P = 0.039, respectively). At a molecular level, we found that TN-ILCs had particular transcriptomic profiles, characterized by increased AR signaling, and associated with frequent alterations in the PI3K network and ERBB2. Interestingly, whole-exome analysis also identified three specific recurrent ESRRA hotspot mutations in these tumors, which have never been described in breast cancer to date and which were absent in the other two tumor subtypes. Our findings highlight that TN-ILC is a unique aggressive breast cancer associated with elderly age, which belong to the luminal androgen receptor subtype as determined by immunohistochemistry and transcriptomic profiling. Moreover, it harbors specific molecular alterations (PI3K, ERBB2 and ESRRA) which may pave the way for new targeted therapeutic strategies.

摘要

原发性三阴性浸润性小叶乳腺癌(TN-ILC)在诊断时不表达激素受体和 HER2,较为罕见且鲜为人知。在这项研究中,我们分析了文献中报道的最大的 TN-ILC 系列,与表型相似的其他乳腺癌亚型进行比较:三阴性浸润性导管癌(TN-IDC)和激素受体阳性浸润性小叶癌(HR+ILC)。我们比较了 2000 年至 2018 年间在我们数据库中登记的所有原发性 TN-ILC(n=38)与通过分期和 Elston/Ellis 分级匹配的对照组肿瘤,比较了临床、病理和免疫组织化学特征。还进行了对比性分子分析(全外显子组和使用下一代技术的 RNA 测序)。我们发现 TN-ILC 患者比 HR+ILC(P=0.002)或 TN-IDC(P<0.001)患者年龄更大。从形态学上看,TN-ILC 具有侵袭性表型,具有更多的多形性(P=0.003)和更高的核级(P=0.009),与 HR+ILC 相比。免疫组织化学显示,TN-ILC 比 TN-IDC 较少表达基底标志物(CK5/6、EGFR 和 SOX10)(P<0.001),而雄激素受体(AR)阳性率更高(P<0.001)。生存曲线分析未显示 TN-ILC 和 TN-IDC 患者之间的差异,而与 HR+ILC 相比,总生存期和无远处转移生存期明显更差(P=0.047 和 P=0.039)。在分子水平上,我们发现 TN-ILC 具有独特的转录组谱,特征是 AR 信号增加,并与 PI3K 网络和 ERBB2 的频繁改变相关。有趣的是,全外显子分析还在这些肿瘤中发现了三个特定的 ESRRA 热点突变,这些突变在乳腺癌中至今尚未被描述,在其他两种肿瘤亚型中也不存在。我们的研究结果表明,TN-ILC 是一种独特的侵袭性乳腺癌,与老年有关,根据免疫组织化学和转录组分析,它属于 luminal 雄激素受体亚型。此外,它还具有特定的分子改变(PI3K、ERBB2 和 ESRRA),这可能为新的靶向治疗策略铺平道路。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验