Basal phenotype identifies a poor prognostic subgroup of breast cancer of clinical importance
Basal phenotype identifies a poor prognostic subgroup of breast cancer of clinical importance
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DOI：
10.1016/j.ejca.2006.08.015
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发表时间：
2006-12-01
影响因子：
8.4
通讯作者：
Ellis, Ian O.
中科院分区：
文献类型：
--
作者：
Rakha, Emad A.;El-Rehim, Dalia Abd;Ellis, Ian O.
背景：乳腺癌被认为是一种异质性疾病，具有一系列形态学表现和行为。最近认识到的基础表型（BP）与生存率差，但这类乳腺癌的临床意义仍然是要充分defined.Methods：我们已经检查了一个良好的特点系列的1872浸润性乳腺癌与长期随访，以评估BP的临床意义。BP作为基础细胞角蛋白CK 5/6和/或CK 14表达的免疫表型证据的实用定义被使用。在我们的研究中，淋巴结阴性和淋巴结阳性亚组中，这些肿瘤与较短的总生存期和无病期相关。当按组织学分级分层时，BP在3级肿瘤中具有高度显著的预后价值，但在1级或2级肿瘤中没有。同样，在诺丁汉预后指数的中度组中，它与生存率差相关，但在其他组中则无关。在LN阴性3级肿瘤的亚组中，BP是最有力的预后标志物，其次是肿瘤大小，而其他变量无显著性。BP患者更有可能对化疗反应比那些与非基底tumors.Conclusions：我们的研究结果提供了有力的证据，BP是一个重要的一类乳腺癌与LN阴性3级疾病患者的特别积极的行为。我们建议常规识别乳腺癌中的BP，并制定有效的辅助治疗策略。这些是重要的观察结果，因为这些肿瘤通常缺乏激素受体和HER-2过表达，限制了相关辅助治疗的范围。(c)2006爱思唯尔有限公司保留所有权利。
Background: Breast cancer is recognised to be a heterogeneous disease with a range of morphological appearances and behaviours. The recently recognised basal phenotype (BP) is associated with poor survival, but the clinical implications of this class of breast cancers remain to be adequately defined.Methods: We have examined a well-characterised series of 1872 invasive breast carcinomas with a long term follow-up to assess the clinical significance of BP.Results: A pragmatic definition of the BP as immunophenotypic evidence of basal cytokeratins CK5/6 and/or CK14 expression was used. These tumours were associated with shorter overall survival and disease-free interval in our series as a whole and in both the lymph node (LN) negative and LN positive subgroups. When stratified by histological grade, BP was of highly significant prognostic value in grade 3 but not in grades 1 or 2 tumours. Similarly, it was associated with poor survival in the moderate group of the Nottingham prognostic Index but not in the other groups. In a subgroup comprising LN negative grade 3 tumours, BP was the most powerful prognostic marker followed only by tumour size, while the other variables were non-significant. Patients with BP were more likely to respond to chemotherapy than those with non-basal tumours.Conclusions: our results provide robust evidence that BP is an important class of breast cancers with a particularly aggressive behaviour in patients with LN negative grade 3 disease. We recommend routine identification of BP in breast cancer and the development of effective adjuvant treatment strategies. These are important observations as these tumours typically lack hormone receptor and HER-2 overexpression limiting the range of relevant adjuvant therapies. (c) 2006 Elsevier Ltd. All rights reserved.