Li B D, Byskosh A, Molteni A, Duda R B
Department of Surgery, Northwestern University Medical School, Chicago, Illinois.
J Surg Oncol. 1994 Oct;57(2):71-7. doi: 10.1002/jso.2930570202.
Estrogen and progesterone receptor status in breast cancer can determine therapeutic options and may provide prognostic information. The purpose of this study is to compare the concordance of the primary breast cancer steroid hormone receptor status to that of the recurrent breast cancer and to determine whether the type of second lesion (local recurrence, second primary, or metastatic lesion) and adjuvant therapy received changed the receptor concordance. The records of eighty-three patients with estrogen receptor (ER) analysis available for primary (p) and recurrent (r) breast cancer for 1976-1990 were reviewed. In addition, 32 of these patients also had available progesterone receptor (PR) values for primary and recurrent breast cancers. Statistical evaluation was performed by chi-square, Student's t-test, and Wilcoxon signed-rank test. ER concordance (primary/recurrent, p/r) was identified in 59/83 (71%) patients; PR concordance was identified in 18/32 (56%) patients. Whether the second lesion was a local recurrence, second primary, or a metastatic lesion did not affect ER concordance or PR concordance. Adjuvant chemotherapy, hormonal therapy, or radiation therapy, either alone or in combination, did not affect ER or PR concordance. The disease-free survival (DFS) for patients with ER (p+)/(r-) (primary receptor positive/recurrent receptor negative) was significantly shorter than those with ER (p-)/(r+)(27.6 +/- 7.4 months versus 50.6 +/- 7.6 mo, P = 0.04). The DFS for PR (p+)/(r-) patients was 28.8 +/- 7.9 months compared to the DFS of 46.8 +/- 11.8 months for PR (p-)/(r+) patients (P = NS). A significantly shorter DFS for ER (p+)/(r-) patients compared to ER (p-)/(r+) patients and a trend towards a shorter DFS for PR (p+)/(r-) patients compared to PR (p-)/(r+) patients may reflect a loss of hormonal regulation or an increase in cancer aggressiveness.
乳腺癌中的雌激素和孕激素受体状态可决定治疗方案，并可能提供预后信息。本研究的目的是比较原发性乳腺癌类固醇激素受体状态与复发性乳腺癌的一致性，并确定第二种病变的类型（局部复发、第二原发性或转移性病变）以及接受的辅助治疗是否会改变受体一致性。回顾了1976年至1990年83例原发性（p）和复发性（r）乳腺癌有雌激素受体（ER）分析记录的患者。此外，这些患者中有32例原发性和复发性乳腺癌也有孕激素受体（PR）值。采用卡方检验、学生t检验和威尔科克森符号秩检验进行统计学评估。59/83（71%）的患者确定有ER一致性（原发性/复发性，p/r）；18/32（56%）的患者确定有PR一致性。第二种病变是局部复发、第二原发性还是转移性病变均不影响ER一致性或PR一致性。辅助化疗、激素治疗或放射治疗，单独或联合使用，均不影响ER或PR一致性。ER（p+）/（r-）（原发性受体阳性/复发性受体阴性）患者的无病生存期（DFS）明显短于ER（p-）/（r+）患者（27.6±7.4个月对50.6±7.6个月，P = 0.04）。PR（p+）/（r-）患者的DFS为28.8±7.9个月，而PR（p-）/（r+）患者的DFS为46.8±11.8个月（P = 无显著性差异）。与ER（p-）/（r+）患者相比，ER（p+）/（r-）患者的DFS明显缩短，与PR（p-）/（r+）患者相比，PR（p+）/（r-）患者的DFS有缩短趋势，这可能反映了激素调节的丧失或癌症侵袭性的增加。
