Genomic instability and prognosis in breast carcinomas
Genomic instability and prognosis in breast carcinomas
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DOI：
10.1158/1055-9965.epi-06-0080
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发表时间：
2006-09-01
影响因子：
3.8
通讯作者：
Pawitan, Yudi
中科院分区：
文献类型：
--
作者：
Kronenwett, Ulrike;Ploner, Alexander;Pawitan, Yudi
背景：我们最近报道，通过二倍体(D)、四倍体(T)和非整倍体(A)类型的细胞计量学评估，乳腺癌的DNA含量可以通过干线散射指数(SSI)进一步分为基因组稳定亚型和不稳定亚型。结果：在D(P=0.04)、T(P=0.008)和A(P=0.004)三种倍体类型中，基因组稳定亚型的生存率显著高于不稳定亚型(P=0.004)。而D型、T型和A型在稳定型(P=0.23)和不稳定亚型(P=0.12)之间的存活率差异无统计学意义。在A类肿瘤中，不稳定的亚型往往比稳定的亚型更大，雌孕激素受体阴性的频率更高，而且分级更高。稳定型D型肿瘤的分级往往低于不稳定亚型，但在D型和T型肿瘤中，基因组不稳定与受体状态无关。在Elston分级3级、淋巴结阳性或雌激素受体阳性亚型中，稳定型肿瘤患者的生存率显著高于不稳定型肿瘤患者(P分别为0.002.0 1、0.0 1和7.2E-5)。目的乳腺癌分为稳定亚型和不稳定亚型是一种独立于临床因素的有用的预后指标。
Background: We recently reported that DNA content of breast adenocarcinomas, cytometrically assessed by diploid (D), tetraploid (T), and aneuploid (A) categories, can be further divided into genomically stable and unstable sub-types by means of the stemline scatter index (SSI). The aim of the present study was to survey the clinical correlates and the prognostic value of the SSI in a consecutive series of 890 breast cancer patients.Results: Genomically stable subtype had a significantly better survival compared with the unstable subtype within each ploidy category: D (P = 0.04), T (P = 0.008), and A (P = 0.004). By contrast, no statistically significant difference in survival was observed between the D, T, and A categories within the stable (P = 0.23) and unstable subtypes (P = 0.12). Among A tumors, the unstable subtype tended to be larger, more frequently estrogen- and progesterone-receptor negative, and to be of higher grade compared with the stable subtype. Stable D tumors tended to have lower grade than the unstable subtype, but among the D and T tumors, genomic instability was not associated with receptor status. Within the Elston grade 3, lymph node-positive or estrogen receptor-positive subgroups, patients with stable tumors had significantly better survival compared with unstable tumors (P = 0.01, 0.002, and 7.2E-5, respectively).Conclusions: The SSI contributes supplementary biological and clinical information in addition to ploidy information alone. Objective classification of breast adenocarcinomas into stable and unstable subtypes is a useful prognostic indicator independent of established clinical factors.