Onitilo Adedayo A, Engel Jessica, Joseph Adedayo O, Li Ya-Huei
Department of Oncology, Marshfield Clinic Health System-Weston Center, 3501 Cranberry Blvd, Weston, WI 54476, USA.
Cancer Care and Research Center, Marshfield Clinic Research Institute, Marshfield, WI 54449, USA.
Ecancermedicalscience. 2021 Aug 24;15:1278. doi: 10.3332/ecancer.2021.1278. eCollection 2021.
The existence of oestrogen receptor-negative (ER-)/progesterone receptor-positive (PR+) breast cancer continues to be an area of controversy amongst oncologists and pathologists.
To re-evaluate breast cancers originally classified as ER-/PR+ via Oncotype DX® assay and compare molecular phenotype with Recurrence Score® (RS) result, clinicopathologic features and clinical outcomes were retrospectively obtained from electronic health records between January 1998 and June 2005. Archived formalin-fixed, paraffin-embedded (FFPE) tumour specimens were tested for the expression of ER, PR and human-epidermal-growth-factor-2. The number of positive ER-/PR+ samples confirmed by transcriptional analysis was the primary outcome of interest with event-free and overall survival as secondary outcomes. Biopsies from 26 patients underwent Oncotype DX testing and analysis.
Approximately 60% were middle-aged (40-50 years old) women, and 84.6% had invasive ductal carcinoma. Based on the Oncotype DX assay, approximately 65% ( = 17) had ER+/PR+ status; 23% (N = 6) had ER-/PR- status; and 12% had a single hormone positive receptor (1 ER-/PR+, 2 ER+/PR-) status. Almost one-quarter of patients were stratified into the low-RS (<18) or intermediate-RS (18-30) results, and half of the patients had a high-RS (>30) result.
Our findings suggest the ER-/PR+ subtype is not a reproducible entity and emphasises the value of retesting this subtype via molecular methods for appropriate treatment selection and patient outcomes. Multigene assay analysis may serve as a second-line or confirming tool for clinical determination of ER/PR phenotype in breast cancer patients for targeted therapies.
雌激素受体阴性（ER-）/孕激素受体阳性（PR+）乳腺癌的存在一直是肿瘤学家和病理学家之间存在争议的领域。
为了重新评估最初通过Oncotype DX®检测分类为ER-/PR+的乳腺癌，并将分子表型与复发评分®（RS）结果进行比较，回顾性地从1998年1月至2005年6月的电子健康记录中获取临床病理特征和临床结局。对存档的福尔马林固定、石蜡包埋（FFPE）肿瘤标本进行ER、PR和人表皮生长因子2表达检测。通过转录分析确认的ER-/PR+阳性样本数量是主要关注结果，无事件生存期和总生存期为次要结果。对26例患者的活检标本进行Oncotype DX检测和分析。
约60%为中年（40 - 50岁）女性，84.6%患有浸润性导管癌。基于Oncotype DX检测，约65%（n = 17）为ER+/PR+状态；23%（n = 6）为ER-/PR-状态；12%为单一激素阳性受体（1例ER-/PR+，2例ER+/PR-）状态。近四分之一的患者被分层为低复发评分（<18）或中等复发评分（18 - 30）结果，一半的患者复发评分高（>30）。
我们的研究结果表明，ER-/PR+亚型不是一个可重复的实体，并强调通过分子方法重新检测该亚型对于适当的治疗选择和患者预后的价值。多基因检测分析可作为乳腺癌患者ER/PR表型临床确定的二线或确认工具，用于靶向治疗。
