Basal-like breast carcinomas: clinical outcome and response to chemotherapy
Basal-like breast carcinomas: clinical outcome and response to chemotherapy
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DOI：
10.1136/jcp.2005.033043
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发表时间：
2006-07-01
影响因子：
3.4
通讯作者：
Smith, I. E.
中科院分区：
文献类型：
--
作者：
Banerjee, S.;Reis-Filho, J. S.;Smith, I. E.
背景资料：III级浸润性导管癌无特殊类型（IDCs-NST）构成了一组异质性肿瘤，具有不同的临床行为和对化疗的反应。已知多达25%的所有III级IDC-NST具有基底样表型，如基底细胞角蛋白的基因表达谱或免疫组织化学所定义。基底样乳腺癌（BLBC）的患者有较短的无病生存期和总survival.Material和方法：49例BLBC（定义为基底细胞角蛋白表达）和49个对照组匹配的年龄，淋巴结状态和等级进行了回顾性分析。结果：与对照组相比，BLBCs患者ER（p < 0.0001）、PgR（p <0.0001）和HER 2（p < 0.01）阴性的可能性更大。发现BLBC患者的复发率显著较高（p < 0.05），并且与无病生存期和总生存期显著较短相关（均为p <0.05）。在接受以蒽环类药物为基础的辅助化疗的患者组中，BLBC组，n = 47;对照组，n = 49），BLBC组的无病生存期和总生存期均显著缩短（p < 0.05）。BLBC是一种独特的临床和病理实体，其特征在于高核级别，缺乏激素受体和HER 2表达以及更具侵袭性的临床过程。标准的辅助化疗似乎是不太有效的，在这些肿瘤和新的治疗方法的指示。
Background: Grade-III invasive ductal carcinomas of no special type (IDCs-NST) constitute a heterogeneous group of tumours with different clinical behaviour and response to chemotherapy. As many as 25% of all grade-III IDCs-NST are known to harbour a basal-like phenotype, as defined by gene expression profiling or immunohistochemistry for basal cytokeratins. Patients with basal-like breast carcinomas (BLBC) are reported to have a shorter disease-free and overall survival.Material and methods: A retrospective analysis of 49 patients with BLBC (as defined by basal cytokeratin expression) and 49 controls matched for age, nodal status and grade was carried out. Histological features, immunohistochemical findings for oestrogen receptor (ER), progesterone receptor (PgR) and HER2, and clinical outcome and survival after adjuvant chemotherapy were compared between the two groups.Results: It was more likely for patients with BLBCs to be found negative for ER (p < 0.0001), PgR (p < 0.0001) and HER2 (p < 0.01) than controls. Patients with BLBCs were found to have a significantly higher recurrence rate (p < 0.05) and were associated with significantly shorter disease-free and overall survival (both p, 0.05). In the group of patients who received anthracycline-based adjuvant chemotherapy (BLBC group, n = 47; controls, n = 49), both disease-free and overall survival were found to be significantly shorter in the BLBC group (p < 0.05).Conclusions: BLBCs are a distinct clinical and pathological entity, characterised by high nuclear grade, lack of hormone receptors and HER2 expression and a more aggressive clinical course. Standard adjuvant chemotherapy seems to be less effective in these tumours and new therapeutic approaches are indicated.