Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
Cancer Research Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
Breast Cancer Res Treat. 2022 Feb;191(3):599-610. doi: 10.1007/s10549-021-06437-8. Epub 2022 Jan 12.
This study developed a triple-negative breast cancer (TNBC) surrogate subtype classification that represents TNBC subtypes based on the Vanderbilt subtype classification.
Patients who underwent primary curative surgery for TNBC were included. Representative FFPE blocks were used for gene expression analysis and tissue microarray construction for immunohistochemical (IHC) staining. The Vanderbilt subtypes were re-classified into four groups: basal-like (BL), mesenchymal-like (M), immunomodulatory (IM) and luminal androgen receptor (LAR) subtype. Classification and regression tree (CART) modeling was applied to develop a surrogate subtype classification.
A total of 145 patients were included. The study cohort was allocated to the Vanderbilt 4 subtypes as LAR (n = 22, 15.2%), IM (n = 32, 22.1%), M (n = 38, 26.2%), BL (n = 25, 17.2%) and unclassified (n = 28, 19.3%). After excluding nine (6.2%) patients due to poor IHC staining quality, CART modeling was performed. TNBC surrogate subtypes were defined as follows: LAR subtype, androgen receptor Allred score 8; IM subtype, LAR-negative with a tumor-infiltrating lymphocyte (TIL) score > 70%; M subtype, LAR-negative with a TIL score < 20%; BL subtype, LAR-negative with a TIL score 20-70% and diffuse, strong p16 staining. The study cohort was classified by the surrogate subtypes as LAR (n = 26, 17.9%), IM (n = 21, 14.5%), M (n = 44, 30.3%), BL1 (n = 27, 18.6%) and unclassified (n = 18, 12.4%). Surrogate subtypes predicted TNBC Vanderbilt 4 subtypes with an accuracy of 0.708.
We have developed a TNBC surrogate subtype classification that correlates with the Vanderbilt subtype. It is a practical and accessible diagnostic test that can be easily applied in clinical practice.
本研究基于范德比尔特（Vanderbilt）分型，开发了一种三阴性乳腺癌（TNBC）替代亚型分类，可根据该分类代表 TNBC 亚型。
纳入接受 TNBC 根治性手术的患者。使用代表性的 FFPE 块进行基因表达分析，并构建组织微阵列进行免疫组化（IHC）染色。将范德比尔特（Vanderbilt）分型重新分为 4 组：基底样（BL）、间质样（M）、免疫调节（IM）和管腔雄激素受体（LAR）亚型。应用分类回归树（CART）模型开发替代亚型分类。
共纳入 145 例患者。该研究队列被分配至范德比尔特（Vanderbilt）4 个亚型，包括 LAR（n=22，15.2%）、IM（n=32，22.1%）、M（n=38，26.2%）、BL（n=25，17.2%）和未分类（n=28，19.3%）。排除 9 例（6.2%）因 IHC 染色质量差的患者后，进行 CART 建模。定义 TNBC 替代亚型如下：LAR 亚型，雄激素受体 Allred 评分 8；IM 亚型，LAR 阴性且肿瘤浸润淋巴细胞（TIL）评分>70%；M 亚型，LAR 阴性且 TIL 评分<20%；BL 亚型，LAR 阴性且 TIL 评分 20-70%且弥漫强 p16 染色。研究队列按替代亚型分为 LAR（n=26，17.9%）、IM（n=21，14.5%）、M（n=44，30.3%）、BL1（n=27，18.6%）和未分类（n=18，12.4%）。替代亚型预测 TNBC 范德比尔特（Vanderbilt）4 个亚型的准确率为 0.708。
我们开发了一种与范德比尔特（Vanderbilt）分型相关的 TNBC 替代亚型分类。它是一种实用且易于获得的诊断测试，可在临床实践中轻松应用。
