University of Malaya Medical Centre, Department of Pathology, 59100 Kuala Lumpur, Malaysia.
University of Malaya, Faculty of Medicine, Department of Pathology, 50603 Kuala Lumpur, Malaysia.
Malays J Pathol. 2023 Dec;45(3):363-374.
Epithelial-mesenchymal transition (EMT) is increasingly explored in cancer progression. Considering that triple negative (TN) breast cancer has the poorest survival among molecular subtypes, we investigated 49 TN, 45 luminal and 25 HER2-enriched female breast carcinomas for EMT expression (using E-cadherin and vimentin immunohistochemistry) against lymphovascular and/or lymph node invasion. E-cadherin and vimentin expressions were semi-quantitated for positive- cancer cells (0=0-<1%, 1=1-10%, 2 =11-50%, 3=>50%) and staining intensity (0=negative, 1=weak, 2=moderate, 3=strong), with final score (low=0-4 and high=6-9) derived by multiplying percentage and intensity scores for each marker. Low E-cadherin and/or high vimentin scores defined EMT positivity. Low E-cadherin co-existing with high vimentin defined "complete" (EMT-CV), while low E-cadherin (EMT-C) or high vimentin (EMT-V) occurring independently defined "partial" subsets. 38 (31.9%) cancers expressed EMT, while 59.2 % TN, 13.3% luminal and 12% HER2-enriched cancers expressed EMT (p<0.05). Among the cancers with lymphovascular and/or lymph node invasion, EMT positivity by molecular types were 66.7% TN, 7.4% luminal and 11.8% HER2-enriched (p<0.05). Although EMT-V, associated with stem-cell properties was the dominant TN EMT profile, EMT-CV, a profile linked to vascular metastases, was encountered only in TN. EMT appears important in TN cancer and different EMT profiles may be associated with its aggressive nature.
上皮-间充质转化（EMT）在癌症进展中越来越受到关注。考虑到三阴性（TN）乳腺癌在分子亚型中存活率最差，我们研究了 49 例 TN、45 例 luminal 和 25 例 HER2 富集的女性乳腺癌，检测 EMT 表达（使用 E-钙黏蛋白和波形蛋白免疫组化）与淋巴血管和/或淋巴结浸润的关系。E-钙黏蛋白和波形蛋白的表达通过阳性癌细胞（0=0-<1%，1=1-10%，2=11-50%，3=>50%）和染色强度（0=阴性，1=弱阳性，2=中度，3=强阳性）进行半定量分析，最终分数（低=0-4，高=6-9）由每个标志物的百分比和强度得分相乘得出。低 E-钙黏蛋白和/或高波形蛋白评分定义为 EMT 阳性。低 E-钙黏蛋白与高波形蛋白共存定义为“完全”（EMT-CV），而低 E-钙黏蛋白（EMT-C）或高波形蛋白（EMT-V）独立发生定义为“部分”亚群。38 例（31.9%）癌症表达 EMT，而 59.2%的 TN、13.3%的 luminal 和 12%的 HER2 富集癌症表达 EMT（p<0.05）。在有淋巴血管和/或淋巴结浸润的癌症中，分子类型的 EMT 阳性率分别为 66.7%的 TN、7.4%的 luminal 和 11.8%的 HER2 富集（p<0.05）。尽管 EMT-V 与干细胞特性相关，是 TN 中 EMT 的主要表型，但 EMT-CV，一种与血管转移相关的表型，仅在 TN 中出现。EMT 在 TN 癌症中似乎很重要，不同的 EMT 表型可能与其侵袭性有关。
