Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Med Sci. 2022 Jan;47(1):40-47. doi: 10.30476/IJMS.2021.88366.1906.
Metastasis is an important factor in the survival estimate of patients with breast cancer. The present study aimed to examine the frequency of epidermal growth factor receptor 2 (HER2), estrogen receptor (ER), and progesterone receptor (PR) expression in relation to the metastatic site, pattern, and tumor size in patients with metastatic breast cancer (MBC).
In this retrospective study, the medical records of patients diagnosed with MBC at Motahari Clinic (Shiraz, Iran) during 2017-2019 were examined. Metastasis was confirmed using computed tomography, and a total of 276 patients were included in the study. Based on the expression of receptors, the patients were categorized into luminal A, luminal B, HER2, and TNBC groups. The frequency and percentage of receptors in relation to the metastatic site, size, and pattern were compared using the Chi square test. P<0.05 was considered statistically significant.
The frequency of receptor positivity in the 276 selected medical records were of the subtype HER2-enriched (n=48), luminal A (n=43), luminal B (n=146), and TNBC (n=39). The most common metastatic sites were the bones (47.1%), lungs (34.4%), liver (27.9%), brain (20.3%), and other organs (12.7%). The first site of metastasis occurred in the bones (36.6%), lungs (17.4%), liver (15.6%), brain (10.5%), and other organs (7.6%). The frequency of receptor expression was different in relation to the first metastatic site (P=0.024). There was a statistically significant difference between the frequency of receptor expression in patients with bone (P=0.036), brain (P=0.031), and lung (P=0.020) metastases. The frequency of receptor expression was also significantly different in relation to the size of liver metastasis (P=0.009). Luminal A and B subtypes showed higher rates of bone metastasis as the first metastatic site.
The difference in the frequency of receptor expression in relation to the metastatic site and tumor size can be used as predictive and prognostic factors in patients with breast cancer.
转移是乳腺癌患者生存估计的一个重要因素。本研究旨在检查表皮生长因子受体 2（HER2）、雌激素受体（ER）和孕激素受体（PR）在转移性乳腺癌（MBC）患者的转移部位、模式和肿瘤大小方面的表达频率。
在这项回顾性研究中，检查了 2017 年至 2019 年在莫塔哈里诊所（伊朗设拉子）诊断为 MBC 的患者的病历。通过计算机断层扫描确认转移，共有 276 名患者纳入研究。根据受体表达情况，将患者分为 luminal A、luminal B、HER2 和三阴性乳腺癌（TNBC）组。使用卡方检验比较受体在转移部位、大小和模式方面的频率和百分比。P<0.05 被认为具有统计学意义。
在 276 份选定的病历中，受体阳性率分别为 HER2 富集型（n=48）、luminal A 型（n=43）、luminal B 型（n=146）和 TNBC 型（n=39）。最常见的转移部位是骨骼（47.1%）、肺部（34.4%）、肝脏（27.9%）、大脑（20.3%）和其他器官（12.7%）。第一个转移部位发生在骨骼（36.6%）、肺部（17.4%）、肝脏（15.6%）、大脑（10.5%）和其他器官（7.6%）。受体表达频率与第一个转移部位有关（P=0.024）。在有骨骼（P=0.036）、大脑（P=0.031）和肺部（P=0.020）转移的患者中，受体表达频率存在统计学差异。受体表达频率与肝转移灶大小也有显著差异（P=0.009）。luminal A 和 B 亚型的骨转移发生率更高，为第一个转移部位。
受体表达频率与转移部位和肿瘤大小的差异可作为乳腺癌患者的预测和预后因素。
