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在 HER2 阴性炎性乳腺癌中，与 ER+/PR+ 表型相比，ER+/PR- 表型表现出更具侵袭性的生物学特征和更差的预后。

ER+/PR- phenotype exhibits more aggressive biological features and worse outcome compared with ER+/PR+ phenotype in HER2-negative inflammatory breast cancer.

机构信息

Department of Thyroid and Breast Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

Department of Thyroid and Breast Surgery, Guigang City People's Hospital, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi, China.

出版信息

Sci Rep. 2024 Jan 2;14(1):197. doi: 10.1038/s41598-023-50755-4.

DOI:10.1038/s41598-023-50755-4
PMID:38167641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10761672/
Abstract

The loss of progesterone receptor (PR) often predicts worse biological behavior and prognosis in estrogen receptor-positive (ER +) breast cancer. However, the impact of PR status on inflammatory breast cancer (IBC) has not been studied. Therefore, the purpose of our study was to investigate the influence of PR on IBC. Patients with ER+ and HER2-negative IBC were selected from the Surveillance, Epidemiology and End Results database. Pearson's χ test was used to compare the clinicopathological characteristics between patients with estrogen receptor-positive/progesterone receptor-positive (ER+/PR +) and patients with estrogen receptor-positive/progesterone receptor-negative (ER+/PR-). Univariate and multivariate analyses were performed to investigate the effects of PR status on the breast cancer-specific survival (BCSS) and overall survival (OS) in IBC. Overall, 1553 patients including 1157 (74.5%) patients with ER+/PR+ and 396 (25.5%) patients with ER+/PR- were analyzed in our study. The patients with ER+/PR- were more likely to be high histological grade (p < 0.001) and liver metastasis (p = 0.045) compared to patients with ER+/PR+. Despite higher chance of receiving chemotherapy (83.6% vs 77.3%, P = 0.008), patients with ER+/PR- showed worse BCSS (5-year BCSS rate, 34.3% vs 51.3%, P < 0.001) and OS (5-year OS rate, 31.3% vs 46.1%, P < 0.001) compared with ER+/PR+ phenotype. Multivariate survival analysis showed that patients with ER+/PR- still had worse BCSS (hazard ratios [HR]: 1.764, 95% confidence intervals [CI] 1.476-2.109, P < 0.001) and OS (HR: 1.675, 95% CI 1.411-1.975, P < 0.001) than ER+/PR+ phenotype. Furthermore, patients with ER+/PR- showed worse outcomes than ER+/PR+ phenotype in most subgroups, especially in patients with younger age (≤ 60 years), lower histological grade, lymph node involved and distant metastasis. Patients with ER+/PR- had more aggressive biological behaviors and worse outcomes than patients with ER+/PR+ in IBC. Stronger treatments maybe needed for IBC patients with ER+/PR-.

摘要

孕激素受体（PR）的缺失通常预示着雌激素受体阳性（ER+）乳腺癌的生物学行为和预后更差。然而，PR 状态对炎性乳腺癌（IBC）的影响尚未得到研究。因此，本研究的目的是探讨 PR 对 IBC 的影响。从监测、流行病学和最终结果数据库中选择了 ER+和 HER2 阴性的 IBC 患者。采用 Pearson χ检验比较了雌激素受体阳性/孕激素受体阳性（ER+/PR+）和雌激素受体阳性/孕激素受体阴性（ER+/PR-）患者的临床病理特征。采用单因素和多因素分析探讨了 PR 状态对 IBC 患者乳腺癌特异性生存（BCSS）和总生存（OS）的影响。本研究共分析了 1553 例患者，其中 1157 例（74.5%）为 ER+/PR+，396 例（25.5%）为 ER+/PR-。与 ER+/PR+的患者相比，ER+/PR-的患者更有可能为高组织学分级（p<0.001）和肝转移（p=0.045）。尽管 ER+/PR-的患者接受化疗的几率更高（83.6% vs 77.3%，P=0.008），但 ER+/PR-的患者 BCSS 更差（5 年 BCSS 率，34.3% vs 51.3%，P<0.001）和 OS 更差（5 年 OS 率，31.3% vs 46.1%，P<0.001）。多因素生存分析显示，与 ER+/PR+表型相比，ER+/PR-的患者仍有更差的 BCSS（风险比[HR]：1.764，95%置信区间[CI]：1.476-2.109，P<0.001）和 OS（HR：1.675，95%CI：1.411-1.975，P<0.001）。此外，ER+/PR-的患者在大多数亚组中比 ER+/PR+的患者预后更差，尤其是在年龄≤60 岁、组织学分级较低、淋巴结受累和远处转移的患者中。与 ER+/PR+表型相比，ER+/PR-的患者在 IBC 中具有更具侵袭性的生物学行为和更差的结局。对于 ER+/PR-的 IBC 患者，可能需要更强的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/f364c9a669fc/41598_2023_50755_Fig5_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/f364c9a669fc/41598_2023_50755_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/b237a17085ee/41598_2023_50755_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/f336e6663e78/41598_2023_50755_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/8d85236223c7/41598_2023_50755_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1734/10761672/1a48c8217f16/41598_2023_50755_Fig4_HTML.jpg
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