Castagnetta L, Traina A, Di Carlo A, Latteri A M, Carruba G, Leake R E
Eur J Cancer Clin Oncol. 1987 Jan;23(1):31-5. doi: 10.1016/0277-5379(87)90415-9.
Both soluble and nuclear oestrogen receptors were measured in at least two different portions of primary breast cancer and in concurrent metastatic tissue from axillary nodes. Oestrogen receptor (ER) status of involved nodes was found highly consistent with that of primary tumours. Of the 67 patients studied, 30 had metastatic nodes which contained both soluble and nuclear ER. Of these, 27 were associated with a primary cancer which also had both soluble and nuclear ER, determined in at least two separate parts of the primary cancer. Conversely, none of the completely negative primaries gave rise to fully receptor positive metastatic tissue. Surprisingly, 17 out of 20 heterogeneous primary tumours, i.e. those containing both receptor positive and negative components, generated receptor negative metastatic nodes. Moreover, in 7 of the 8 patients with N-2 stage nodal involvement, the metastatic disease had arisen from primaries which were either completely receptor negative or with a heterogeneous ER status. It is suggested that macroscopic heterogeneity of ER status in primary breast cancer is associated with poor prognosis.
在原发性乳腺癌的至少两个不同部位以及来自腋窝淋巴结的同期转移组织中,对可溶性雌激素受体和核雌激素受体均进行了检测。发现受累淋巴结的雌激素受体(ER)状态与原发性肿瘤高度一致。在研究的67例患者中,有30例转移淋巴结同时含有可溶性ER和核ER。其中,27例与原发性癌相关,原发性癌在至少两个不同部位检测也同时含有可溶性ER和核ER。相反,完全阴性的原发性肿瘤均未产生完全受体阳性的转移组织。令人惊讶的是,20例异质性原发性肿瘤(即同时含有受体阳性和阴性成分的肿瘤)中有17例产生了受体阴性的转移淋巴结。此外,在8例N-2期淋巴结受累患者中的7例中,转移病灶源自完全受体阴性或ER状态异质性的原发性肿瘤。提示原发性乳腺癌中ER状态的宏观异质性与预后不良相关。