The differences between pure and mixed invasive micropapillary breast cancer: the epithelial-mesenchymal transition molecules and prognosis.

IF 3 3区 医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-11-01 Epub Date: 2024-07-02 DOI:10.1007/s10549-024-07384-w
Ozden Oz, Resmiye Irmak Yuzuguldu, Ayse Yazici, Demet Kocatepe Cavdar, Cengiz Yilmaz, Mucteba Ozturk, Hilal Duzel, Duygu Gurel
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Abstract

Purpose: Invasive micropapillary carcinoma (IMPC) of the breast is known for its high metastatic potential, but the definition of pure and mixed IMPC remains unclear. This retrospective cohort study aims to investigate the prognostic significance of the micropapillary component ratio and the expression of critical molecules of epithelial-mesenchymal transition (EMT), including E-cadherin (E-cad), N-cadherin (N-cad), CD44s, and β-catenin (β-cat), in distinguishing between pure and mixed IMPCs.

Methods: We analyzed 100 cases of locally advanced IMPC between 2000 and 2018 and excluded patients who received neoadjuvant chemotherapy. Pure IMPC was defined as having a micropapillary component of over 90%. A comprehensive recording of prognostic parameters was conducted. The IMPC areas were analyzed using the immunohistochemical (IHC) staining method on the microarray set for pure and mixed IMPC patients. Pearson's chi-square, Fisher's exact tests, Kaplan-Meier analysis, and Cox proportional hazards analysis were employed.

Results: The comparative survival analysis of the entire group, based on overall survival (OS) and disease-free survival (DFS), revealed no significant difference between the pure and mixed groups (P = 0.480, HR = 1.474 [0.502-4.325] and P = 0.390, HR = 1.587 [0.550-4.640], respectively). However, in the pure IMPC group, certain factors were found to be associated with a higher risk of short survival. These factors included skin involvement (P = 0.050), pT3&4 category (P = 0.006), a ratio of intraductal component (> 5%) (P = 0.032), and high-level expression of N-cad (P = 0.020). Notably, none of the risk factors identified for short OS in pure IMPC cases were observed as significant risks in mixed cases and vice versa. Furthermore, N-cad was identified as a poor prognostic marker for OS in pure IMPCs (P = 0.002).

Conclusion: The selection of a 90% ratio for classifying pure IMPCs revealed significant differences in certain molecular and prognostic parameters between pure and mixed groups. Notably, the involvement of N-cadherin in the epithelial-mesenchymal transition (EMT) process provided crucial insights for predicting OS and DFS while also distinguishing between the two groups. These findings strongly support the notion that the pure IMPC subgroup represents a distinct entity characterized by unique molecular characteristics and behavioral patterns.

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纯性和混合性浸润性微乳头状瘤的差异:上皮-间质转化分子和预后。
目的:众所周知,乳腺浸润性微乳头状癌(IMPC)具有很高的转移潜力,但纯合性和混合性IMPC的定义仍不明确。这项回顾性队列研究旨在探讨微乳头成分比例和上皮-间质转化(EMT)关键分子(包括E-cadherin(E-cad)、N-cadherin(N-cad)、CD44s和β-catenin(β-cat))的表达对区分纯合型和混合型IMPC的预后意义:我们分析了2000年至2018年间的100例局部晚期IMPC,并排除了接受新辅助化疗的患者。纯IMPC定义为微乳头成分超过90%。对预后参数进行了全面记录。采用免疫组化(IHC)染色法对纯合IMPC和混合IMPC患者的微阵列集进行IMPC区域分析。采用了皮尔逊卡方检验、费雪精确检验、Kaplan-Meier分析和Cox比例危险度分析:结果:基于总生存期(OS)和无病生存期(DFS)的全组生存期比较分析显示,纯合组和混合组之间无显著差异(分别为 P = 0.480,HR = 1.474 [0.502-4.325] 和 P = 0.390,HR = 1.587 [0.550-4.640])。然而,在纯 IMPC 组中,发现某些因素与较高的短期存活风险相关。这些因素包括皮肤受累(P = 0.050)、pT3&4 类(P = 0.006)、导管内成分比例(> 5%)(P = 0.032)和 N-cad 的高水平表达(P = 0.020)。值得注意的是,在纯IMPC病例中发现的导致短OS的风险因素在混合病例中均无明显风险,反之亦然。此外,N-cad被确定为纯IMPC患者OS的不良预后标志物(P = 0.002):结论:选择 90% 的比例对纯 IMPCs 进行分类,发现纯 IMPCs 和混合组之间在某些分子和预后参数上存在显著差异。值得注意的是,N-cadherin参与上皮-间质转化(EMT)过程为预测OS和DFS提供了重要依据,同时也区分了两组患者。这些发现有力地支持了这样一种观点,即纯合子 IMPC 亚组代表了一个不同的实体,具有独特的分子特征和行为模式。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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