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报告乳腺癌中的激素受体表达:哪种方法具有最高的预后价值,最佳临界值应该是多少?

Reporting Hormone Receptor Expression in Breast Carcinomas: Which Method has the Highest Prognostic Power and What Should be the Optimal Cut-off Value?

作者信息

Öztürk Çiğdem, Okcu Oğuzhan, Öztürk Seda Duman, Şen Bayram, Öztürk Ahmet Emin, Bedir Recep

机构信息

Pathology Department, Recep Tayyip Erdoğan University, Training and Research Hospital, Rize, Türkiye.

Pathology Department, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Türkiye.

出版信息

Int J Surg Pathol. 2025 Apr;33(2):353-362. doi: 10.1177/10668969241265068. Epub 2024 Sep 8.

Abstract

.Hormone receptor (HR) expression is a critical marker that plays a role in the treatment and management of breast cancer. Even if patients receive hormone treatment with a hormone positivity rate of over 1%, it is controversial at what level of positivity they benefit from treatment and contribute positively to their prognosis..We retrospectively examined the estrogen receptor (ER) / progesterone receptor (PR) expression status, clinicopathological findings, and survival data of 386 patients who underwent surgery for breast cancer. ER/PR expressions of the patients were evaluated according to Allred, H-score and were also grouped according to staining percentages. Separate cut-off values were determined for each of these evaluation methods, and the prognostic power of these methods was investigated using receiver operating characteristic analysis..The prognostic power of all methods was found to be similar in terms of predicting survival. According to the staining percentage of the patients, survival was excellent if the ER value was >80% and the PR value was >1%..All recommended methods for reporting HRs have similar prognostic power. However, in patients with high percentage staining for ER using these methods, the prognosis is excellent. As a result, we predict that if the percentage of ER staining is low, changing the treatment management of patients may be considered clinically.

摘要

激素受体(HR)表达是一个关键标志物,在乳腺癌的治疗和管理中发挥作用。即使患者接受激素阳性率超过1%的激素治疗,关于他们在何种阳性水平能从治疗中获益并对预后产生积极影响仍存在争议。我们回顾性研究了386例接受乳腺癌手术患者的雌激素受体(ER)/孕激素受体(PR)表达状态、临床病理特征及生存数据。根据艾尔雷德(Allred)法、H评分评估患者的ER/PR表达,并根据染色百分比进行分组。为每种评估方法确定了单独的临界值,并使用受试者工作特征分析研究这些方法的预后预测能力。在预测生存方面,所有方法的预后预测能力相似。根据患者的染色百分比,若ER值>80%且PR值>1%,则生存情况良好。所有推荐的HR报告方法都具有相似的预后预测能力。然而,使用这些方法时,ER染色百分比高的患者预后良好。因此,我们预测,如果ER染色百分比低,临床上可能考虑改变患者的治疗管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b646/11915773/7658f7df5eb6/10.1177_10668969241265068-fig1.jpg

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