使用PR和PIK3CA生物标志物预测乳腺癌预后：诊断组的比较分析

Predicting breast cancer prognosis using PR and PIK3CA biomarkers: a comparative analysis of diagnostic groups.

作者信息

Feng Yuting, Song Qingzhen, Yan Lei, Li Ruoqi, Yang Mengqin, Bu Peng, Lian Jing

机构信息

Department of Pathology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi Province, 030013, People's Republic of China.

School of Basic Medicine, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.

出版信息

BMC Cancer. 2025 Jan 13;25(1):68. doi: 10.1186/s12885-025-13449-w.

DOI:10.1186/s12885-025-13449-w

PMID:39806274

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11727184/

Abstract

PURPOSE

To evaluate the prognostic significance of progesterone receptor (PR) expression and the PIK3CA mutation status in HR+/HER2 - breast cancer patients, with the goal of screening patients who may derive the greatest benefit from PI3K-targeted therapy.

METHODS

A retrospective analysis was conducted on 152 HR+/HER2 - breast cancer patients stratified by PR expression levels and PIK3CA mutation status. The study population was divided into groups on the basis of a median PR threshold of 50% and further subdivided by PIK3CA mutation status. To evaluate the variability of clinicopathologic features among these groups, t tests and ANOVA were employed. The influence of these variables on survival was analyzed via Cox regression. Additionally, a risk prediction model was developed using the PR expression level and PIK3CA mutation status. The prognostic utility of this model was examined via both Kaplan‒Meier (KM) survival curves and receiver operating characteristic (ROC) analyses. These methods have also been utilized to explore the associations between clinicopathologic parameters and clinical outcomes with respect to survival prediction and prognosis.

RESULTS

Significant differences in age, ER expression, and Ki67, HER2, and PIK3CA mutation status were detected between the groups (P < 0.05). Specifically, elevated PR expression was correlated with lower levels of Ki67 and low HER2 expression. The presence of a PIK3CA mutation was significantly linked to survival outcomes according to both univariate and multivariate Cox regression analyses. Moreover, ROC analysis revealed that models incorporating both PR expression and PIK3CA mutation status achieved the highest level of diagnostic precision (AUC = 0.82).

CONCLUSION

PR expression and PIK3CA mutation status are significant prognostic markers in HR+/HER2 - breast cancer patients. Assessing these biomarkers in combination can enhance prognostic stratification, potentially guiding more informed clinical decision-making.

摘要

目的

评估孕激素受体（PR）表达和PIK3CA突变状态在激素受体阳性/人表皮生长因子受体2阴性（HR+/HER2−）乳腺癌患者中的预后意义，旨在筛选出可能从PI3K靶向治疗中获益最大的患者。

方法

对152例HR+/HER2−乳腺癌患者进行回顾性分析，根据PR表达水平和PIK3CA突变状态进行分层。研究人群根据PR阈值中位数50%分为几组，并进一步按PIK3CA突变状态细分。为评估这些组间临床病理特征的变异性，采用了t检验和方差分析。通过Cox回归分析这些变量对生存的影响。此外，利用PR表达水平和PIK3CA突变状态建立了风险预测模型。通过Kaplan-Meier（KM）生存曲线和受试者工作特征（ROC）分析检验该模型的预后效用。这些方法也被用于探索临床病理参数与生存预测和预后方面临床结局之间的关联。

结果

各组间在年龄、雌激素受体（ER）表达、Ki67、HER2和PIK3CA突变状态方面存在显著差异（P < 0.05）。具体而言，PR表达升高与Ki67水平降低和HER2低表达相关。根据单因素和多因素Cox回归分析，PIK3CA突变的存在与生存结局显著相关。此外，ROC分析显示，结合PR表达和PIK3CA突变状态的模型实现了最高水平的诊断精度（曲线下面积[AUC]=0.82）。