不同分子分型的HR阴性乳腺癌临床病理特征及预后的研究

doi:10.3969/j.issn.1004-616x.2013.02.013

癌变·畸变·突变

不同分子分型的HR阴性乳腺癌临床病理特征及预后的研究

陈燕枝,卢山珊,万丽,黄卡特,杨开颜*

温州医学院附属第一医院病理科，浙江温州 325000

收稿日期:2012-11-09 修回日期:2013-03-02 出版日期:2013-03-30 发布日期:2013-03-30
通讯作者: 杨开颜，E-mail：yky310@yahoo.com.cn
作者简介:陈燕枝 (1987- )，女，江西省上饶市人，硕士研究生，研究方向：肿瘤病理学。
基金资助:
温州市科技局科研项目 (H20100015)

The molecular phenotypes of hormone receptor-negative invasive breast cancers: clinicopathologic features and prognosis

CHEN Yan-zhi，LU Shan-shan，WAN Li，HUANG Ka-te，YANG Kai-yan*

Department of Pathology, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China

Received:2012-11-09 Revised:2013-03-02 Online:2013-03-30 Published:2013-03-30
Contact: YANG Kai-yan，E-mail：yky310@yahoo.com.cn

摘要/Abstract

摘要：

目的：探讨激素受体 (hormone receptor，HR)阴性浸润性乳腺癌的分子分型情况，以及不同分子分型的临床病理特征和预后?方法：应用组织芯片技术及免疫组化将所选200例HR阴性[包括雌激素受体 (estrogen receptor，ER)和孕激素受体 (progesterone receptor ，PR)均为阴性]浸润性乳腺癌，依据HER2及基底细胞标记[包括细胞角蛋白5/6 (cytokeratin 5/6，CK5/6)，细胞角蛋白14 (cytokeratin14，CK14)及上皮生长因子受体 (epidermal growth factor receptor，EGFR)]表达情况，分为以下类型：HER2过表达型、基底细胞样型及裸型；HER2过表达型又分两类亚型：单纯性HER2过表达型、基底细胞样-HER2过表达型；比较不同分子分型乳腺癌的病理特征及预后。结果：HR阴性乳腺癌具有病理分级高，临床分期晚，发病年龄近绝经期等特点，各分型间差异无统计学意义；基底细胞样-HER2过表达型远处转移率高于基底细胞样型 (P<0.05)，其5年无病生存率及5年总生存率低于各分型 (P<0.05)。结论：基底细胞样型并非影响乳腺癌预后的独立因素，基底细胞样-HER2过表达型乳腺癌较基底细胞样型具有更差的预后情况。

关键词: HR阴性乳腺癌, 号分子分型, 号基底细胞样型, 号基底样-HER2过表达型, 号预后

Abstract:

OBJECTIVE: To explore the molecular phenotypes of hormone receptor (HR，including ER and PR)-negative invasive breast cancers，and how the phenotypes relate to clinicopathologic features and prognosis. METHODS：Using tissue microarray (TMA) and immunohistochemistry (IHC) methods，according to the expression of HER2 and basal markers (CK5/6，CK14， EGFR)，the subtypes of these HR-negative breast cancers were classified as follows：basal-like (HER2?，any of the basal marker+)，HER2 (HER2+)，and null/unclassified (HER2?，all the basal marker?). The phenotype HER2 was subdivided into pure-HER2 (HER2+，all the basal marker?) and basal-HER2 phenotype (HER2+，any of the basal marker+). We summarized the associations between each phenotype and clinicopathologic parameters，and compared the mean survival across the IHC subtypes. RESULTS：HR-negative invasive breast cancers was more likely to be high-grade，late-stage，and disease onset close to menopause. But with no significant difference among various molecular phenotypes. Patients with basal-HER2 phenotype had significantly poorer 5-year disease-free survival and 5-year overall survival than with basal-like tumors (P <0 .05). CONCLUSION：Basal-like phenotype was not an independent prognostic factor. Basal-HER2 phenotype showed significantly poorer 5-year overall and disease-free survival than basal-like and all the non basal-HER2 phenotypes in HR-negative breast cancers.

Key words: HR-negative invasive breast cancers, molecular phenotypes, basal-like phenotype, basal-HER2 phenotype, prognosis

陈燕枝,卢山珊,万丽,黄卡特,杨开颜. 不同分子分型的HR阴性乳腺癌临床病理特征及预后的研究[J]. 癌变·畸变·突变, doi: 10.3969/j.issn.1004-616x.2013.02.013.

CHEN Yan-zhi，LU Shan-shan，WAN Li，HUANG Ka-te，YANG Kai-yan. The molecular phenotypes of hormone receptor-negative invasive breast cancers: clinicopathologic features and prognosis[J]. Carcinogenesis, Teratogenesis & Mutagenesis, doi: 10.3969/j.issn.1004-616x.2013.02.013.

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不同分子分型的HR阴性乳腺癌临床病理特征及预后的研究

The molecular phenotypes of hormone receptor-negative invasive breast cancers: clinicopathologic features and prognosis

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