Department of General Surgery, China Medical University Hospital, Taichung, Taiwan.
Department of Medical Operation, Amwise Diagnostics Pte. Ltd., Singapore.
Biosci Rep. 2022 Jan 28;42(1). doi: 10.1042/BSR20211706.
Breast cancer is the most common cancer and the leading cause of cancer-related deaths in women. The estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are the important biomarkers in the prognosis of breast cancer, and their expression is used to categorize breast cancer into subtypes. We aimed to analyze the concordance among ER, PR, and HER2 expression levels and breast cancer subtyping results obtained by immunohistochemistry (IHC, for protein) and reverse transcriptase-polymerase chain reaction (RT-PCR, for mRNA) and to assess the recurrence-free survival (RFS) of the different subtypes as determined by the two methods. We compared biomarker expression by IHC and RT-PCR in 397 operable breast cancer patients and categorized all patients into luminal, HER2, and triple-negative (TN) subtypes. The concordance of biomarker expression between the two methods was 81.6% (κ = 0.4075) for ER, 87.2% (κ = 0.5647) for PR, and 79.1% (κ = 0.2767) for HER2. The κ-statistic was 0.3624 for the resulting luminal, HER2, and TN subtypes. The probability of 5-year RFS was 0.78 for the luminal subtype versus 0.77 for HER2 and 0.51 for TN, when determined by IHC (P=0.007); and 0.80, 0.71, and 0.61, respectively, when determined by the RT-PCR method (P=0.008). Based on the current evidence, subtyping by RT-PCR performs similar to conventional IHC with regard to the 5-year prognosis. The PCR method may thus provide a complementary means of subtyping when IHC results are ambiguous.
乳腺癌是最常见的癌症,也是女性癌症相关死亡的主要原因。雌激素受体 (ER)、孕激素受体 (PR) 和人表皮生长因子受体 2 (HER2) 是乳腺癌预后的重要生物标志物,其表达用于将乳腺癌分为亚型。我们旨在分析免疫组织化学 (IHC,用于蛋白质) 和逆转录聚合酶链反应 (RT-PCR,用于 mRNA) 检测到的 ER、PR 和 HER2 表达水平与乳腺癌亚型分类结果之间的一致性,并评估两种方法确定的不同亚型的无复发生存率 (RFS)。我们比较了 397 例可手术乳腺癌患者的 IHC 和 RT-PCR 检测的生物标志物表达,并将所有患者分为 luminal、HER2 和三阴性 (TN) 亚型。两种方法检测生物标志物表达的一致性分别为 ER 81.6%(κ=0.4075)、PR 87.2%(κ=0.5647)和 HER2 79.1%(κ=0.2767)。κ 统计量为 0.3624,用于 luminal、HER2 和 TN 三种亚型。当通过 IHC 确定时,luminal 亚型的 5 年 RFS 概率为 0.78,HER2 为 0.77,TN 为 0.51(P=0.007);当通过 RT-PCR 方法确定时,分别为 0.80、0.71 和 0.61(P=0.008)。根据目前的证据,RT-PCR 亚分型与传统 IHC 相比,5 年预后相似。因此,当 IHC 结果不明确时,PCR 方法可能是一种补充的亚分型方法。
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