Nguyen Chu Van, Nguyen Quang Tien, Vu Ha Thi Ngoc, Pham Khoa Hong, Phung Huyen Thi
Department of Quan Su Pathology, National Cancer Hospital Vietnam.
National Cancer Hospital Vietnam.
Int J Clin Exp Pathol. 2021 Mar 1;14(3):322-337. eCollection 2021.
The Bhagarva surrogate molecular subtype definitions classify invasive breast cancer into seven the different subgroups based on immunohistochemical (IHC) criteria according to expression levels of markers as ER, PR, HER2, EGFR and/or basal cytokeratin (CK5/6) which are different in prognosis and responsiveness to adjuvant therapy.
The present study aimed to classify primary breast cancers and directly compares the prognostic significance of the intrinsic subtypes.
The current study was conducted on 522 breast cancer patients who had surgery, but had not received neoadjuvant chemotherapy, from 2011 to 2014. The clinicopathologic characteristics were recorded. IHC staining was performed for ER, PR, HER2, Ki67, CK5/6, EGFR and D2-40 markers. All breast cancer patients were stratified according to Bhagarva criteria. The followed-up patients' survival was analyzed by using Kaplan-Meier and Log-Rank models.
The luminal A (LUMA) was observed at the highest rate (32.5%). Non-basal-like triple negative phenotype (TNB-) and Luminal A HER2-Hybrid (LAHH) were the least common (3.3% in both). LUMA and luminal B (LUMB) were significantly associated with better prognostic features compared to HER2, basal-like triple negative phenotype (TNB+) and TNB-. Statistically significant differences were demonstrated between overall survival (OS), disease-free survival (DFS) and molecular subtypes (P<0.05), of which LUMB and LUMA had the highest rate of OS and DFS being 97.2 and 93.7%; and 97.2 and 90.5%, respectively. Conversely, HER2 revealed the worst prognosis with the lowest prevalence of OS and DFS (72.5 and 69.9%, respectively).
The molecular subtypes had a distinct OS and DFS. The intrinsic stratification displayed inversely to clinicopathological features in breast cancer.
巴加瓦替代分子亚型定义根据雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）、表皮生长因子受体（EGFR）和/或基底细胞角蛋白（CK5/6）等标志物的表达水平，通过免疫组织化学（IHC）标准将浸润性乳腺癌分为七个不同亚组，这些亚组在预后和对辅助治疗的反应性方面存在差异。
本研究旨在对原发性乳腺癌进行分类，并直接比较内在亚型的预后意义。
本研究对2011年至2014年期间522例接受了手术但未接受新辅助化疗的乳腺癌患者进行。记录临床病理特征。对ER、PR、HER2、Ki67、CK5/6、EGFR和D2-40标志物进行IHC染色。所有乳腺癌患者均根据巴加瓦标准进行分层。采用Kaplan-Meier法和Log-Rank模型分析随访患者的生存率。
管腔A型（LUMA）的发生率最高（32.5%）。非基底样三阴性表型（TNB-）和管腔A型HER2杂交型（LAHH）最不常见（均为3.3%）。与HER2、基底样三阴性表型（TNB+）和TNB-相比，LUMA和管腔B型（LUMB）与更好的预后特征显著相关。总生存期（OS）、无病生存期（DFS）和分子亚型之间存在统计学显著差异（P<0.05），其中LUMB和LUMA的OS和DFS发生率最高，分别为97.2%和93.7%；以及97.2%和90.5%。相反，HER2的预后最差，OS和DFS的患病率最低（分别为72.5%和69.9%）。
分子亚型具有不同的OS和DFS。内在分层与乳腺癌的临床病理特征呈相反关系。
