乳腺癌肝转移中的受体转化与存活。

Receptor conversion and survival in breast cancer liver metastases.

机构信息

Department of Surgical and Perioperative Sciences/Surgery, Umeå University, 901 85, Umeå, Sweden.

Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

出版信息

Breast Cancer Res. 2023 Sep 13;25(1):105. doi: 10.1186/s13058-023-01706-4.

DOI:10.1186/s13058-023-01706-4

PMID:37705026

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10500900/

Abstract

BACKGROUND

Breast cancer liver metastases (BCLM) is a common cause of breast cancer-related death. The prognostic and predictive value of receptor expression and St Gallen classification is challenged by receptor status discordance in distant metastases. The aim of this study was to determine the rate of receptor conversion from breast cancer to BCLM and the impact on survival.

METHOD

Patients registered with BCLM in two Swedish national cancer registers were recruited retrospectively. Data on receptor expression in primary breast cancer and BCLM were collected, as well as information about predictive factors for survival. The rate of receptor and subtype conversion was analyzed. A Cox regression model was used to investigate predictive factors for survival.

RESULTS

A cohort of 132 patients with BCLM was identified. Estrogen receptor (ER), progesterone receptor (PgR) and HER2 converted in 17, 33 and 10%, respectively. PgR was lost in BCLM while 8/10 HER2 conversions went from negative to positive. The BC subtype was re-classified in 21% of the BCLM. Median survival after BCLM was 13 months and HER2 amplification was associated with improved survival (HR 0.28 CI 0.085-0.90). The highest predictive value (Harrell´s C-index) was obtained when including both BC and BCLM status.

CONCLUSIONS

Receptor and subtype conversions are common in BCLM, and a liver biopsy is warranted to tailor BCLM treatment. HER2 amplification is associated with improved survival in a BCLM cohort.

摘要

背景

乳腺癌肝转移（BCLM）是乳腺癌相关死亡的常见原因。受体表达和圣加仑分类的预后和预测价值受到远处转移中受体状态不一致的挑战。本研究旨在确定从乳腺癌到 BCLM 的受体转换率及其对生存的影响。

方法

回顾性招募在两个瑞典国家癌症登记处登记为 BCLM 的患者。收集原发性乳腺癌和 BCLM 中受体表达的数据，以及与生存相关的预测因素信息。分析受体和亚型转换的比率。使用 Cox 回归模型研究生存的预测因素。

结果

确定了 132 例 BCLM 患者的队列。雌激素受体（ER）、孕激素受体（PgR）和 HER2 分别转换了 17%、33%和 10%。PgR 在 BCLM 中丢失，而 10 例 HER2 转换从阴性变为阳性。21%的 BCLM 重新分类为 BC 亚型。BCLM 后的中位生存时间为 13 个月，HER2 扩增与生存改善相关（HR 0.28 CI 0.085-0.90）。当同时包含 BC 和 BCLM 状态时，获得了最高的预测价值（Harrell 氏 C 指数）。