Predominance of the basal type and HER-2/neu type in brain metastasis from breast cancer
Predominance of the basal type and HER-2/neu type in brain metastasis from breast cancer
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DOI：
10.1038/modpathol.3800830
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发表时间：
2007-08-01
期刊：
影响因子：
7.5
通讯作者：
Kreipe, Hans H.
中科院分区：
文献类型：
--
作者：
Gaedcke, Jochen;Traub, Frank;Kreipe, Hans H.
尽管乳腺癌是中枢神经系统(CNS)转移的第二大常见原因，发病率显著增加，但关于脑转移的乳腺癌的研究很少。在这项免疫组织化学和荧光原位杂交(FISH)研究中，对85例中枢神经转移癌和44例已知累及中枢神经系统的乳腺癌(包括配对的原发癌和转移癌23例)的雌激素(ER)和孕激素(PR)受体、HER-2/neu、表皮生长因子受体(EGFR)、Ki-67和细胞角蛋白(CKS)5/14的表达进行了回顾性研究。大多数脑转移瘤是类固醇激素受体阴性(ER 66%，PR 82%)，与已知的CNS受累原发肿瘤(68%ER阴性，PR 82%)相对应。75%PR阴性)。HER-2/neu过表达或扩增的癌在两组中的发生率分别为34%和32%。转移性肿瘤中EGFR的表达(41%)高于原发肿瘤(16%)。具有基本表型的病例比例分别为26%和30%。在配对的原发肿瘤和中枢神经系统转移瘤中，87%的病例观察到HER-2/neu状态稳定，仅1例HER-2/neu阴性，2例脑转移瘤HER-2/neu过度表达/扩增。相比之下，类固醇激素受体表现出更多的表达缺失(17%)而不是增加(9%)，其中74%表现为恒定的表型。我们认为脑转移性乳腺癌主要属于基础型或HER-2/neu型。原发肿瘤和转移性肿瘤只在少数情况下不同，导致类固醇激素受体的丢失和EGFR和HER-2/neu的增加。
Although breast cancer is the second most common cause of central nervous system (CNS) metastases with a notable increase of incidence, only few studies on brain-metastasizing breast cancer are available. In this immunohistochemical and fluorescence in situ hybridization ( FISH) study, metastases to the CNS (n=85) and primary breast cancers, with known involvement of the CNS (n=44) including paired primary and metastasized tumours (n=23), were investigated retrospectively for the expression of oestrogen-(ER) and progesterone-(PR) hormone receptors, Her-2/neu, epidermal growth factor receptor ( EGFR), Ki-67, and cytokeratins (CKs) 5/14. The majority of brain metastases were steroid hormone receptor negative (ER 66%, PR 82%) corresponding to the findings in primary tumours with known involvement of the CNS (68% ER-negative, 75% PR-negative). The frequency of HER-2/neu-overexpressing or -amplified cancers was increased in both groups (34 and 32%, respectively). EGFR expression was more frequent in metastases (41%) than in primary tumours (16%). The proportions of cases with a basal phenotype were 26 and 30%, respectively. In paired primary tumours and metastases to the CNS, constancy of Her-2/neu status was observed in 87% of cases with only one sample turning Her-2/neu-negative and two samples acquiring overexpression/amplification in brain metastases. In contrast, steroid hormone receptors exhibited more frequently a loss of expression (17%) than a gain (9%) with 74% revealing a constant phenotype. We conclude that brain-metastasizing breast cancer belongs predominantly to the basal type or Her-2/neu type. Primary and metastatic tumours differ from each other only in a minority of cases, leading rather to a loss of steroid hormone receptors and to a gain of EGFR and Her-2/neu.