Ismail Allyzain, Panjwani Sajida, Ismail Neelam, Ngimba Caroline, Mosha Innocent, Adebayo Philip, Mwanga Ally, Zehri Ali Akbar, Njau Aidan, Athar Ali
Department of Surgery, Aga Khan University Medical College, Dar es Salaam, Tanzania.
Department of Family Medicine, Aga Khan University Medical College, Dar es Salaam, Tanzania.
Heliyon. 2024 Sep 26;10(19):e38493. doi: 10.1016/j.heliyon.2024.e38493. eCollection 2024 Oct 15.
Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and is categorised into 4 subtypes. Data in Tanzania was lacking and was based off data extrapolated from studies in Western Africa thus hypothesizing that women of African ancestry predominately develop Triple Negative Breast Cancer (TNBC).
A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015 to 2022. Prevalence of each molecular subtype was determined and association between molecular subtype to demographic and pathological characteristics were evaluated. Predictors of molecular subtypes was then determined using logistic regression.
Total number of participants were 1214, median age was 50 (IQR: 41-61), median tumor size was 5 cm (IQR: 4-7) with lymph node positivity in 73.7 %. Immunohistochemistry studies showed estrogen, progesterone and Human Epidermal Growth Factor Receptor 2 (HER2) receptor positivity in 54.4 %, 34.4 % and 27.8 % of cases respectively. Molecular subtype classification prevalence for Luminal A was 21.17 % (95 % CI: 18.87-23.47), for Luminal B 35.75 % (95 % CI: 33.05-38.45), for HER2 enriched 11.86 % (95 % CI: 10.04-13.68) and for TNBC 31.22 % (95 % CI: 28.61-33.83). Significant association was seen between molecular subtype with age, tumor size, tumor grade and lymph node involvement. Predictors of Luminal tumors were larger tumor size (aOR 1.217, 95 % CI: 1.149-1.291) no lymph node involvement (aOR 0.429, 95 % CI: 0.313-0.589) while an advanced tumor grade reduced likelihood (aOR 0.041, 95 % CI: 0.011-0.019).
In Tanzania Luminal B was most predominant subtype presenting at an earlier age and associated with more favorable pathological characteristics.
乳腺癌免疫组化是肿瘤的一种生物学特征，对诊断分子亚型、预测预后及指导治疗具有重要作用，可分为4种亚型。坦桑尼亚缺乏相关数据，相关数据是根据西非研究推断得出，因此推测非洲裔女性主要罹患三阴性乳腺癌（TNBC）。
在两家三级转诊医院开展一项回顾性横断面研究，研究对象为2015年至2022年从癌症登记处招募的参与者。确定每种分子亚型的患病率，并评估分子亚型与人口统计学和病理特征之间的关联。然后使用逻辑回归确定分子亚型的预测因素。
参与者总数为1214人，中位年龄为50岁（四分位间距：41 - 61岁），中位肿瘤大小为5厘米（四分位间距：4 - 7厘米），73.7%的患者有淋巴结转移。免疫组化研究显示，雌激素、孕激素和人表皮生长因子受体2（HER2）受体阳性率分别为54.4%、34.4%和27.8%。腔面A型分子亚型分类患病率为21.17%（95%置信区间：18.87 - 23.47），腔面B型为35.75%（95%置信区间：33.05 - 38.45），HER2富集型为11.86%（95%置信区间：10.04 - 13.68），TNBC为31.22%（95%置信区间：28.61 - 33.83）。分子亚型与年龄、肿瘤大小、肿瘤分级和淋巴结受累之间存在显著关联。腔面型肿瘤的预测因素为肿瘤较大（调整后比值比1.217，95%置信区间：1.149 - 1.291）、无淋巴结转移（调整后比值比0.429，95%置信区间：0.313 - 0.589），而肿瘤分级高则可能性降低（调整后比值比0.041，95%置信区间：0.011 - 0.019）。
在坦桑尼亚，腔面B型是最主要的亚型，发病年龄较早，且与更有利的病理特征相关。
