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中国西北地区乳腺癌患者PIK3CA突变的临床病理特征及预后分析

Clinicopathological characteristics and prognostic analysis of PIK3CA mutation in breast cancer patients in Northwest China.

作者信息

Lv Wei, Du Chong, Zhang Yinbing, Wu Fei, Jin Yaofeng, Chen Xi, Liu Xuan, Feng Cong, Ma Xingcong, Zhang Shuqun

机构信息

Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.

Department of Pathology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.

出版信息

Pathol Res Pract. 2022 Oct;238:154063. doi: 10.1016/j.prp.2022.154063. Epub 2022 Aug 10.

Abstract

PURPOSE

Multiple studies on PIK3CA mutations in breast cancer (BC) had been performed, which showed the controversial results among different countries and races even those from the same country. The present study aimed to explore the PIK3CA gene mutation status in BC patients in Northwest China and reveal the relationship between PIK3CA mutations and clinicopathological features along with prognosis.

MATERIALS AND METHODS

1002 BC patients from Northwest China were recruited in this study, genomic DNA was extracted from formalin-fixed paraffin-embedded (FFPE) tumor tissues, and hotspot mutations in the exon 9 and 20 of PIK3CA gene were detected by ARMS-PCR.

RESULTS

PIK3CA mutations were found in 31.2% (313/1002) of BC patients, among them 66.1% were mutations in exon 20% and 32.6% were mutations in exon 9. H1047R was the most common mutation type, accounting for 56.5% of the total mutated samples. Significant correlations were observed between PIK3CA mutation status and age (P = 0.035), histopathologic types (P = 0.004), pathological grade (P = 0.013), ER positivity (P < 0.001), PR positivity (P < 0.001), molecular subtypes (P = 0.004) and family history (P = 0.007). Cox multivariate analysis showed that patients with mutations in exon 9 or 20 had shorter DFS and OS than wild-type patients. Those with exon 9 mutations subgroup had the worst prognosis. Interestingly, patients with H1047L mutation had the best prognosis than others.

CONCLUSION

PIK3CA mutations could be used as an indicator of clinical outcome or targeted therapy for multiple breast cancer subgroups in Northwest China.

摘要

目的

已开展多项关于乳腺癌(BC)中PIK3CA突变的研究,结果显示不同国家和种族(甚至同一国家内)的研究结果存在争议。本研究旨在探索中国西北地区BC患者的PIK3CA基因突变状态,并揭示PIK3CA突变与临床病理特征及预后之间的关系。

材料与方法

本研究纳入了1002例来自中国西北地区的BC患者,从福尔马林固定石蜡包埋(FFPE)肿瘤组织中提取基因组DNA,采用ARMS-PCR检测PIK3CA基因外显子9和20的热点突变。

结果

在31.2%(313/1002)的BC患者中发现了PIK3CA突变,其中66.1%为外显子20突变,32.6%为外显子9突变。H1047R是最常见的突变类型,占总突变样本的56.5%。观察到PIK3CA突变状态与年龄(P = 0.035)、组织病理学类型(P = 0.004)、病理分级(P = 0.013)、ER阳性(P < 0.001)、PR阳性(P < 0.001)、分子亚型(P = 0.004)和家族史(P = 0.007)之间存在显著相关性。Cox多因素分析显示,外显子9或20发生突变的患者的无病生存期(DFS)和总生存期(OS)比野生型患者短。外显子9突变亚组的患者预后最差。有趣的是,H1047L突变患者的预后比其他患者最佳。

结论

PIK3CA突变可作为中国西北地区多个乳腺癌亚组临床结局或靶向治疗的指标。

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