Kim Su Hwa, Lee Young Suk, Lee Sung Hak, Sung Yeoun Eun, Lee Ahwon, Kang Jun, Park Jae-Sung, Jeun Sin Soo, Lee Youn Soo
Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Pathol Transl Med. 2023 Jul;57(4):217-231. doi: 10.4132/jptm.2023.06.10. Epub 2023 Jul 11.
The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM).
A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary's Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results.
Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively.
We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor's molecular pathology.
转移性脑肿瘤是最常见的脑肿瘤。本研究的目的是阐述脑转移瘤(BM)的临床病理及分子病理特征。
2010年1月至2020年3月期间,共有269例患者在首尔圣母医院通过手术切除被诊断为BM。我们利用免疫组织化学和分子病理学结果,回顾了原发性和转移性脑组织的临床病理特征及分子状态。
269例患者中,男性139例,女性130例。原发性肿瘤的中位年龄为58岁(范围13至87岁),86例患者(32.0%)初诊时即有BM。无BM间隔时间的中位数为28.0个月(范围1至286个月)。最常见的原发部位是肺,占46.5%(125/269),其次是乳腺,占15.6%(42/269),结直肠占10.0%(27/269)。分别在50.8%(32/63)的肺原发性肿瘤和58.0%(40/69)的肺转移瘤中发现表皮生长因子受体(EGFR)突变。在原发性乳腺癌和伴有BM的乳腺癌中,管腔B型分别是最常见的亚型,占37.9%(11/29)和42.9%(18/42),其次是人类表皮生长因子受体2型,分别占31.0%(9/29)和33.3%(14/42)。三阴性分别占原发性乳腺癌和乳腺转移瘤的20.7%(6/29)和16.7%(7/42),管腔A型分别占10.3%(3/29)和7.1%(3/42)。在原发性结直肠癌和伴有BM的结直肠癌中,分别在76.9%(10/13)和66.7%(2/3)中发现KRAS突变。
我们报告了BM的临床病理及分子病理特征,可为理解转移机制及基于肿瘤分子病理学的临床试验提供有用信息。