Elledge R M, Ciocca D R, Langone G, McGuire W L
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7884.
Cancer. 1993 Apr 15;71(8):2499-506. doi: 10.1002/1097-0142(19930415)71:8<2499::aid-cncr2820710812>3.0.co;2-s.
Because the occurrence of breast cancer during pregnancy is uncommon and because the high levels of estrogens and progestins associated with pregnancy could cause false-negative results from ligand binding assays (LBA), the actual incidence of steroid hormone receptor positivity in tumors from this subset of women is unclear.
Estrogen receptor (ER) and progesterone receptor (PgR) were determined using LBA methods in 15 tumors from 15 pregnant patients with breast cancer. In addition, immunohistochemistry was done for ER, PgR, pS2, heat shock protein 27 (hsp27), and HER-2/neu on 12 of the 15 tumors.
Five of 15 (33%) tumors were positive for ER by LBA, compared with 52% of tumors from age-matched nonpregnant patients. Six of 12 (50%) were ER-positive by immunohistochemistry. For PgR, 7 of 15 (47%) tumors were positive by LBA, compared with 42% of tumors from nonpregnant patients. Ten of 12 (83%) stained positive for PgR. By LBA, 67% of tumors studied were positive for ER or PgR or both, as opposed to 57% of tumors from the nonpregnant comparison group. Two other estrogen receptor-mediated proteins, pS2 and hsp27, were present by staining in 8 of 12 (67%) and 10 of 12 (83%) of tumors, respectively. Seven of 12 tumors (58%) had positive staining for HER-2/neu, whereas only 16% of age-matched nonpregnant patients had positive-staining tumors.
By LBA, the incidence of ER and PgR in breast tumors from pregnant women was not significantly different from that of tumors from nonpregnant age-matched patients. Some ER-negative tumors were PgR, pS2, or hsp27 positive, indicating that an intact estrogen response system was operative although ER was not detectable by standard LBA.
由于孕期乳腺癌的发生并不常见，且与妊娠相关的高水平雌激素和孕激素可能导致配体结合分析（LBA）出现假阴性结果，因此这部分女性肿瘤中类固醇激素受体阳性的实际发生率尚不清楚。
采用LBA方法对15例妊娠乳腺癌患者的15个肿瘤进行雌激素受体（ER）和孕激素受体（PgR）检测。此外，对15个肿瘤中的12个进行了ER、PgR、pS2、热休克蛋白27（hsp27）和HER-2/neu的免疫组化检测。
15个肿瘤中有5个（33%）通过LBA检测ER呈阳性，而年龄匹配的非妊娠患者肿瘤的这一比例为52%。12个肿瘤中有6个（50%）通过免疫组化检测ER呈阳性。对于PgR，15个肿瘤中有7个（47%）通过LBA检测呈阳性，非妊娠患者肿瘤的这一比例为42%。12个肿瘤中有10个（83%）PgR染色呈阳性。通过LBA检测，所研究的肿瘤中有67%的ER或PgR或两者均呈阳性，而在非妊娠对照组中这一比例为57%。另外两种雌激素受体介导的蛋白pS2和hsp27，分别在12个肿瘤中的8个（67%）和10个（83%）中染色呈阳性。12个肿瘤中有7个（58%）HER-2/neu染色呈阳性，而年龄匹配的非妊娠患者中只有16%的肿瘤染色呈阳性。
通过LBA检测，孕妇乳腺肿瘤中ER和PgR的发生率与年龄匹配的非妊娠患者肿瘤的发生率无显著差异。一些ER阴性肿瘤的PgR、pS2或hsp27呈阳性，表明尽管标准LBA检测不到ER，但完整的雌激素反应系统仍在起作用。
