Biologic and clinical characteristics of breast cancer with single hormone receptor-positive phenotype
Biologic and clinical characteristics of breast cancer with single hormone receptor-positive phenotype
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DOI：
10.1200/jco.2007.12.2747
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发表时间：
2007-10-20
影响因子：
45.3
通讯作者：
Ellis, Ian O.
中科院分区：
文献类型：
--
作者：
Rakha, Emad A.;El-Sayed, Maysa E.;Ellis, Ian O.
目的乳腺癌内分泌治疗的疗效与雌激素受体（ER）和孕激素受体（PgR）状态有关。它通常是更容易决定治疗策略的情况下，双阳性/阴性表型比在单阳性tumors.Patients和方法，我们已经研究了一个大的和良好的特点系列的原发性浸润性乳腺癌（1,944例）的长期临床随访和激素治疗的数据。根据ER和PgR表达对患者进行分层，研究集中在单阳性组（ER-/PgR+和ER+/PgR-），以评估其主要特征，并评估它们之间的任何预后和预测差异，并将其与双阳性/阴性肿瘤进行比较。大多数为2级导管癌/无特定类型癌。在淋巴结分期方面，两组之间没有差异。生存分析显示两组在无病期和总生存期方面无差异。然而，当与双阴性表型相比时，ER+/PgR-显示出与更好的结果相关，但在ER-/PgR+肿瘤的情况下没有检测到这种生存优势。在接受辅助激素治疗的ER+肿瘤患者组中，PgR缺失（ER+/PgR-）是复发和生存期缩短的独立预测因子，因此，结论ER+/PgR-和ER-/PgR+乳腺癌在生物学和临床上是两组不同的乳腺癌，ER-/PgR+可能需要不同的治疗策略表现出更具攻击性的行为特征
Purpose Response to endocrine therapy in breast cancer correlates with estrogen receptor (ER) and progesterone receptor (PgR) status. It is usually easier to decide treatment strategies in cases of double-positive/-negative phenotypes than in single-positive tumors.Patients and Methods We have examined a large and well-characterized series of primary invasive breast carcinoma (1,944 cases) with long-term clinical follow-up and hormone therapy data. Patients were stratified according to ER and PgR expression and the study was focused on the single-positive groups (ER-/PgR+ and ER+/PgR-), to assess their main features and evaluate any prognostic and predictive difference between them and compare them with the double-positive/-negative tumors.Results ER+/PgR-tumors were found more frequently in elderly, postmenopausal women. The majority were grade 2 ductal/no specific type carcinomas. There was no difference between the two groups with regard to lymph node stage. Survival analyses showed no difference between the two groups in terms of disease-free interval and overall survival. However, when compared with the double-negative phenotype, ER+/PgR-showed an association with better outcome but no such survival advantage was detected in case of ER-/PgR+tumors. In the group of patients with ER+ tumors who received adjuvant hormonal therapy, absence of PgR (ER+/PgR-) was an independent predictor of development of recurrence and shorter survival and, hence, poorer response to hormonal therapy.Conclusion ER+/PgR-and ER-/PgR+tumors are biologically and clinically distinct groups of breast cancer that may require different treatment strategies with ER-/PgR+exhibiting more aggressive behavioral characteristics.