Jakesz R, Dittrich C, Hanusch J, Kolb R, Lenzhofer R, Moser K, Rainer H, Reiner G, Schemper M, Spona J
Ann Surg. 1985 Mar;201(3):305-10. doi: 10.1097/00000658-198503000-00008.
Estrogen (ER), progesterone (PgR), and androgen (AR) receptors were measured in two simultaneous or subsequent specimens taken each from 259 patients with breast cancer. We studied in 182 patients results from receptor assays, either from one tumor or from the primary tumor, and a lymph node metastasis, and in 77 sequential biopsies with or without intervening therapy. All assays were performed in a single laboratory, considering 10 fmol/mg cytosol protein bound ligand as receptor positive. The concordance rate in simultaneous ER assays was 85%; however, we found a considerable high discordance rate for PgR in primary tumor and lymph node metastasis (25%). The overall discordance rate in sequential biopsies for ER was 38% and for PgR 25%. This discordance rate was primarily dependent on the receptor quality of the first assay (ER+: 50%, ER-: 24%, PgR+: 68%, PgR-: 9%). Considering only the ER+ and PgR+ cases, we found the greatest discordance rate in the patients having endocrine treatment following the first biopsy (55% and 84%, respectively). We conclude that the receptor status of one tumor biopsy is highly representative for other tumor or lymph node biopsies. Because of the high discordance rate of primarily receptor + cases in subsequent recurrences, the receptor quality of these lesions should be analyzed whenever possible.
在259例乳腺癌患者中，对同时采集或先后采集的两份标本检测雌激素（ER）、孕激素（PgR）和雄激素（AR）受体。我们研究了182例患者的受体检测结果，这些结果来自一个肿瘤或原发肿瘤及一个淋巴结转移灶，还研究了77例接受或未接受中间治疗的序贯活检标本。所有检测均在单个实验室进行，将结合配体的细胞溶质蛋白≥10 fmol/mg视为受体阳性。同时检测ER时的符合率为85%；然而，我们发现原发肿瘤和淋巴结转移灶中PgR的不一致率相当高（25%）。序贯活检中ER的总体不一致率为38%，PgR为25%。这种不一致率主要取决于首次检测的受体质量（ER阳性：50%，ER阴性：24%，PgR阳性：68%，PgR阴性：9%）。仅考虑ER阳性和PgR阳性病例，我们发现首次活检后接受内分泌治疗的患者中不一致率最高（分别为55%和84%）。我们得出结论，一次肿瘤活检的受体状态对其他肿瘤或淋巴结活检具有高度代表性。由于后续复发中主要是受体阳性病例的不一致率较高，应尽可能分析这些病变的受体质量。
