Discipline of Management, Legislation and Communication in Dental Medicine, Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania;
Rom J Morphol Embryol. 2022 Apr-Jun;63(2):421-429. doi: 10.47162/RJME.63.2.13.
Breast cancer (BrCa) is the most frequent malignancy in female, and lymph node metastases (LNM) is an important prognostic and therapeutic parameter. The molecular classification is nowadays largely applied to characterize the primary tumors, but few studies focused on the comparison between the molecular profiles of the primary with corresponding LNM. In the current work, we investigated the expression of conventional markers used by molecular classification in both primary tumors and axillary LNM. A series of 156 patients with BrCa was investigated, and from these 80 cases showed LNM. After routine pathological investigation, including the histopathological form and grade, we performed additional step sections from the primary and lymph nodes for immunohistochemistry. All procedures for hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki67, cytokeratin 5 (CK5), epidermal growth factor receptor (EGFR), p53, E-cadherin, and B-cell leukemia∕lymphoma-2 (Bcl-2) were performed using the standard automated procedures. We found significant differences between the primary tumors and corresponding LNM in luminal A, luminal B, and basal-like carcinoma. No phenotypical interconversions were noticed in HER2 and unclassified BrCa. Our data demonstrate that in almost 20% of the cases the molecular profile of the primary does not overlap with aspects found in the lymph nodes. Our results strongly suggest performing the molecular classification in both primary tumors and in LNM. Current data suggest that the application of this diagnostic procedure will significantly influence the therapeutic strategy.
乳腺癌（BrCa）是女性最常见的恶性肿瘤，淋巴结转移（LNM）是一个重要的预后和治疗参数。目前，分子分类已广泛应用于对原发性肿瘤进行特征描述，但很少有研究关注原发性肿瘤和相应的淋巴结转移之间的分子谱比较。在目前的工作中，我们研究了分子分类中常用的常规标志物在原发性肿瘤和腋窝淋巴结转移中的表达。我们对 156 例乳腺癌患者进行了研究，其中 80 例患者出现淋巴结转移。在进行常规病理检查，包括组织病理学形态和分级后，我们从原发性肿瘤和淋巴结中进行了额外的免疫组织化学切片。所有激素受体、人表皮生长因子受体 2（HER2）、Ki67、细胞角蛋白 5（CK5）、表皮生长因子受体（EGFR）、p53、E-钙黏蛋白和 B 细胞白血病/淋巴瘤-2（Bcl-2）的检测程序均采用标准自动化程序进行。我们发现 luminal A、luminal B 和基底样癌的原发性肿瘤和相应的淋巴结转移之间存在显著差异。HER2 和未分类的 BrCa 中未观察到表型转化。我们的数据表明，在近 20%的病例中，原发性肿瘤的分子谱与淋巴结中发现的特征不重叠。我们的结果强烈建议在原发性肿瘤和淋巴结转移中均进行分子分类。目前的数据表明，这种诊断程序的应用将显著影响治疗策略。
