雌激素阴性/孕激素阳性(ER−/PR+)表型对1159例原发性乳腺癌患者的预后及预测价值

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Breast Journal Pub Date : 2022-05-17 DOI:10.1155/2022/9238804
S. Gamrani, S. Boukansa, Z. Benbrahim, N. Mellas, F. F. Fdili Alaoui, M. Melhouf, C. Bouchikhi, A. Banani, M. Boubbou, T. Bouhafa, H. El fatemi
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引用次数: 3

摘要

癌症是一个严重的全球性公共卫生问题,也是目前最常见的癌症。其内分泌治疗与类固醇激素、雌激素受体(ER)和孕激素受体(PR)的表达有关。乳腺癌可表现为多种类固醇激素:ER(−)/PR(+)、ER(+)/PR、双阳性/阴性ER和PR。2-8%的乳腺癌仅表达PR(ER−/PR+),这是一种异常表型,对其行为和结果知之甚少。我们的研究是在一个大型且特征良好的癌症数据库中进行的,从2012年到2019年,多达1159例。根据ER和PR表达对这些病例进行了分类,因为我们将所有注意力都放在了ER阴性/PR阳性组,更具体地说是ER−/PR+/HER2+和ER−/PR+/HER2−基因表达上,以突出它们的特征,并找到将HR(激素受体)图谱与乳腺癌症亚型联系起来的模式。在信息丰富的病例中,94名患者(8%)患有ER+/PR+乳腺癌,676名患者(58.4%)患有ER+/-PR+,88名患者(7.6%)患有ER+/-,164名患者(14.2%)患有ER−/PR-肿瘤。在双阴性和双阳性HR之间,ER−/PR+组与高复发和死亡风险具有统计学相关性。根据HER2状态,在ER−/PR+/HER2−患者中观察到低DFS,这更接近TNBC病例的DFS,但比ER+/PR更差。另一方面,在TNBC和ER+/PR-any之间,ER−/PR+/HER2+也显示出更接近HER2+亚组的较差DFS。ER−/PR+/HER2−和ER−/PR+HER2+的临床病理特征将患者分为两组,在一些临床病理特征上存在差异:两组的OS估计值都更接近,比ER−/PR-any差,比TNBC和HER2好。与ER+/PR-any相比,ER−/PR+/HER2+似乎比ER−/PR+/HER2+增加了复发风险。另一方面,与ER+/PR-any相比,ER-/PR+/HER2+似乎比ER+/PR+/HER2-更能增加死亡风险。我们的研究结果支持ER−/PR+肿瘤确实存在,并且是罕见的、临床和生物学上不同的癌症亚型。此外,我们的分析基于根据HER2表达划分组,揭示了两个不同组的存在;这使ER−/PR+亚组具有异质性特征。此外,这种癌症亚型不应被视为管腔肿瘤,而应根据HER2的表达状态进行治疗。
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The Prognosis and Predictive Value of Estrogen Negative/Progesterone Positive (ER−/PR+) Phenotype: Experience of 1159 Primary Breast Cancer from a Single Institute
Breast cancer is a serious worldwide public health problem and is currently the most common cancer overall. Its endocrine therapy is related to the expression of the steroid hormones, estrogen receptor (ER), and progesterone receptor (PR). Breast cancers can be presented under multiple profiles of steroid hormones: ER(−)/PR(+), ER(+)/PR(−), double-positive/negative ER, and PR. 2–8% of all breast cancers express only PR (ER−/PR+) which is an abnormal phenotype, with less known about their behaviors and outcomes. Our study was performed on a large and well-characterized database of primary breast cancer from 2012 to 2019, up to 1159 cases. These cases were divided according to ER and PR expression, as we put all of our focus on ER-negative/PR-positive group, more specifically ER−/PR+/HER2+ and ER−/PR+/HER2− gene expressions, to highlight their features and find a pattern that links HR (hormone receptors) profiles and breast cancer subtypes. Out of the informative cases, 94 patients (8%) had ER−/PR+ breast cancers, while 676 (58.4%) had ER+/PR+, 88 (7.6%) had ER+/PR−, and 164 (14.2%) had ER−/PR− tumors. The ER−/PR+ group was statistically correlated with a high risk of recurrence and death in midway between the double-negative and double-positive HR. According to HER2 status, a low DFS was observed in patients ER−/PR+/HER2−, which is closer to the DFS of TNBC cases but worse than ER+/PR any. On the other side, the ER−/PR+/HER2+ showed also a poorer DFS closer to the HER2+ subgroup in between TNBC and ER+/PR any. The clinicopathological features of the ER−/PR+/HER2− and ER−/PR+ HER2+ have distinguished the patients into two groups with a difference in some clinicopathological characteristics: both groups had closer OS estimation, which was worse than ER−/PR any and better than TNBC and HER2. The ER−/PR+/HER2− seems to increase the risk of recurrence than ER−/PR+/HER2+ when compared to ER+/PR any. On the other hand, the ER−/PR+/HER2+ seems to increase the risk of death more than ER−/PR+/HER2− in comparison with ER+/PR any. Our results support that ER−/PR+ tumors really exist and are rare and clinically and biologically distinct subtypes of breast cancer. In addition, our analysis, which was based on dividing the groups according to HER2 expression, has revealed the existence of two distinct groups; this gave the ER−/PR+ subgroup a heterogeneity characterization. Moreover, this breast cancer subtype should not be treated as a luminal tumor but rather according to the HER2 expression status.
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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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