Should liver metastases of breast cancer be biopsied to improve treatment choice?
Should liver metastases of breast cancer be biopsied to improve treatment choice?
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DOI：
10.1093/annonc/mdq751
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发表时间：
2011-10-01
影响因子：
50.5
通讯作者：
Goldhirsch, A.
中科院分区：
文献类型：
--
作者：
Curigliano, G.;Bagnardi, V.;Goldhirsch, A.
背景：目前，从转移的沉积物中获取组织并不被推荐为常规做法。我们的目的是评估雌激素受体(ER)、孕激素受体(PGR)和人表皮生长因子受体2(HER2)受体状态在原发肿瘤和肝转移瘤之间的不符合率及其对治疗选择的潜在影响。患者和方法：我们回顾分析了1999年8月至2009年3月在欧洲肿瘤研究所进行的1250例超声引导下肝活检的数据库。用免疫组织化学和/或FISH方法检测ER、PGR和HER2的表达。用Fisher‘s精确检验评估不同比例之间的差异。结果：我们确定了255名连续的患者，这些患者的原发组织和肝脏组织样本都是匹配的。255例患者中有37例(14.5%)出现ER状态改变。255例患者中有124例(48.6%)观察到PGR状态的改变。172名可评估患者中有24名(13.9%)观察到HER2状态的变化。我们观察到原发肿瘤和肝转移瘤的受体状态(ER、PGR和HER2)不一致，这导致255名患者中有31名(12.1%)改变了治疗。结论：所有患者都应该考虑对转移瘤进行活检以重新评估生物学特征，因为这可能会影响治疗选择。
Background: Currently, the acquisition of tissue from metastatic deposits is not recommended as a routine practice. Our aim was to evaluate the discordance rate of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) receptor status between primary tumor and liver metastases and its potential impact on treatment choice.Patients and methods: We retrospectively analyzed a database including 1250 ultrasound-guided liver biopsies carried out at the European Institute of Oncology from August 1999 to March 2009. ER, PgR, and HER2 status were determined by immunohistochemistry and/or FISH. Differences between proportions were evaluated using Fisher's exact test.Results: We identified 255 consecutive patients with matched primary and liver tissue samples. Changes in ER status were observed in 37 of 255 patients (14.5%). Changes in PgR status were observed in 124 of 255 patients (48.6%). Changes in HER2 status were observed in 24 of 172 assessable patients (13.9%). We observed a discordance in receptor status (ER, PgR, and HER2) between primary tumor and liver metastases, which led to change in therapy for 31 of 255 of patients (12.1%).Conclusions: Biopsy of metastases for reassessment of biological features should be considered in all patients, when safe and easy to carry out, since it is likely to impact treatment choice.