Molecular Characterization and Mortality From Breast Cancer in Men
Molecular Characterization and Mortality From Breast Cancer in Men
复制标题
DOI：
10.1200/jco.2017.76.8861
复制
发表时间：
2018-05-10
影响因子：
45.3
通讯作者：
Shak, Steven
中科院分区：
文献类型：
--
作者：
Massarweh, Suleiman Alfred;Sledge, George W.;Shak, Steven
目的关于男性乳腺癌的分子生物学、治疗和预后的数据有限，我们在这方面的大部分了解主要是从女性乳腺癌患者的数据中推断出来的。材料和方法我们研究了荷尔蒙受体阳性乳腺癌患者和女性患者以及21基因乳腺癌复发评分(RS)结果。结果共有3,806名男性和571,115名女性参与研究。男性比女性年龄大(平均年龄64.2岁比59.1岁；P<；.001)。RS<；18在男女中均占优势，但RS 31在男性中更常见(12.4%比7.4%；P<；.001)，得分很低(RS<；11；33.8%比22.1%；P<；.001)。在雌激素受体(ER)、增殖和侵袭组中，男性的平均基因表达较高。50岁以下女性ER最低，孕激素受体最高，ER随年龄增长呈递增趋势。与年龄较大的男性相比，年龄在50岁以下的男性ER和黄体酮受体略低。SEER提供了322名男性和55,842名女性的生存数据。男性RS<；18和RS 18-30的5年BCS分别为99.0%(95%CI，99.3%~99.9%)和95.9%(95%CI，87.6%~98.7%)，女性分别为99.5%(95%CI，99.4%~99.6%)和98.6%(95%CI，98.4%~98.8%)。男性RS 31的5年BCS为81.0%(95%CI，53.3%至93.2%)，女性为94.9%(95%CI，93.9%至95.7%)。男性的5年BCS和总生存率低于女性。结论本研究揭示了男性乳腺癌的一些独特的生物学特征，RS检测在男性和女性中都具有重要的预后作用。
PurposeLimited data exist on the molecular biology, treatment, and outcomes of breast cancer in men, and much of our understanding in this area remains largely an extrapolation from data in women with breast cancer.Materials and MethodsWe studied men and women with hormone receptor-positive breast cancer and the 21-gene Breast Recurrence Score (RS) results. Differences in clinical characteristics and gene expression were determined, and distribution of RS results was correlated with 5-year breast cancer-specific survival (BCSS) and overall survival.ResultsThere were 3,806 men and 571,115 women. Men were older than women (mean age, 64.2 v 59.1 years; P < .001). RS < 18 predominated in both genders, but RS 31 was more frequent in men (12.4% v 7.4%; P < .001), as were very low scores (RS < 11; 33.8% v 22.1%; P < .001). Mean gene expression was higher in men for the estrogen receptor (ER), proliferation, and invasion groups. ER was lowest and progesterone receptor was highest in women younger than 50 years of age, with a progressive increase in ER with age. Men younger than 50 years of age had slightly lower ER and progesterone receptor compared with older men. Survival data were available from SEER for 322 men and 55,842 women. Five-year BCSS was 99.0% (95% CI, 99.3% to 99.9%) and 95.9% (95% CI, 87.6% to 98.7%) for men with RS < 18 and RS 18-30, respectively, and for women, it was 99.5% (95% CI, 99.4% to 99.6%) and 98.6% (95% CI, 98.4% to 98.8%), respectively. RS 31 was associated with an 81.0% 5-year BCSS in men (95% CI, 53.3% to 93.2%) and 94.9% 5-year BCSS (95% CI, 93.9% to 95.7%) in women. Five-year BCSS and overall survival were lower in men than in women.ConclusionThis study reveals some distinctive biologic features of breast cancer in men and an important prognostic role for RS testing in both men and women.