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基于 PAM50 基因表达检测的浸润性乳腺癌分子分型——与基于肿瘤分级/免疫组化的分子分型的比较及对肿瘤医生在真实世界中选择全身治疗方案的影响。

Molecular Subtyping of Invasive Breast Cancer Using a PAM50-Based Multigene Expression Test-Comparison with Molecular-Like Subtyping by Tumor Grade/Immunohistochemistry and Influence on Oncologist's Decision on Systemic Therapy in a Real-World Setting.

机构信息

Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.

Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany.

出版信息

Int J Mol Sci. 2022 Aug 5;23(15):8716. doi: 10.3390/ijms23158716.


DOI:10.3390/ijms23158716
PMID:35955851
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9368794/
Abstract

In intermediate risk hormone receptor (HR) positive, HER2 negative breast cancer (BC), the decision regarding adjuvant chemotherapy might be facilitated by multigene expression tests. In all, 142 intermediate risk BCs were investigated using the PAM50-based multigene expression test Prosigna® in a prospective multicentric study. In 119/142 cases, Prosigna® molecular subtyping was compared with local and two central (C1 and C6) molecular-like subtypes relying on both immunohistochemistry (IHC; HRs, HER2, Ki-67) and IHC + tumor grade (IHC+G) subtyping. According to local IHC, 35.4% were Luminal A-like and 64.6% Luminal B-like subtypes (local IHC+G subtype: 31.9% Luminal A-like; 68.1% Luminal B-like). In contrast to local and C1 subtyping, C6 classified >2/3 of cases as Luminal A-like. Pairwise agreement between Prosigna® subtyping and molecular-like subtypes was fair to moderate depending on molecular-like subtyping method and center. The best agreement was observed between Prosigna® (53.8% Luminal A; 44.5% Luminal B) and C1 surrogate subtyping (Cohen’s kappa = 0.455). Adjuvant chemotherapy was suggested to 44.2% and 88.6% of Prosigna® Luminal A and Luminal B cases, respectively. Out of all Luminal A-like cases (locally IHC/IHC+G subtyping), adjuvant chemotherapy was recommended if Prosigna® testing classified as Prosigna® Luminal A at high / intermediate risk or upgraded to Prosigna® Luminal B.

摘要

在激素受体(HR)阳性、HER2 阴性的中危乳腺癌(BC)中,多基因表达检测可辅助决定辅助化疗。在一项前瞻性多中心研究中,使用基于 PAM50 的多基因表达检测 Prosigna®对 142 例中危 BC 进行了检测。在 142 例病例中,119 例将 Prosigna®分子亚型与局部和两个中心(C1 和 C6)的分子样亚型进行了比较,这些亚型依赖于免疫组化(IHC;HRs、HER2、Ki-67)和 IHC+肿瘤分级(IHC+G)分型。根据局部 IHC,35.4%为 Luminal A 样,64.6%为 Luminal B 样亚型(局部 IHC+G 亚型:31.9%为 Luminal A 样;68.1%为 Luminal B 样)。与局部和 C1 分型相比,C6 将>2/3 的病例分类为 Luminal A 样。根据分子样亚型检测方法和中心的不同,Prosigna®分型与分子样亚型之间的一致性为中等至良好。Prosigna®(53.8%为 Luminal A;44.5%为 Luminal B)与 C1 替代分型(Cohen’s kappa=0.455)之间的一致性最好。Prosigna®Luminal A 和 Luminal B 病例分别建议进行辅助化疗 44.2%和 88.6%。在所有 Luminal A 样病例(局部 IHC/IHC+G 分型)中,如果 Prosigna®检测将病例分类为高/中危 Prosigna®Luminal A 或升级为 Prosigna®Luminal B,则建议进行辅助化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/754b94a486af/ijms-23-08716-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/3c65c65cb15e/ijms-23-08716-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/f647f6e7b5e7/ijms-23-08716-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/a71672226d7f/ijms-23-08716-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/a1e61d623022/ijms-23-08716-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/754b94a486af/ijms-23-08716-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/3c65c65cb15e/ijms-23-08716-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/f647f6e7b5e7/ijms-23-08716-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/a71672226d7f/ijms-23-08716-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/a1e61d623022/ijms-23-08716-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f434/9368794/754b94a486af/ijms-23-08716-g005.jpg

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