Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype.
Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype.
复制标题
DOI：
10.1186/bcr3462
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Beck AH
中科院分区：
文献类型：
--
作者：
Hefti MM;Hu R;Knoblauch NW;Collins LC;Haibe-Kains B;Tamimi RM;Beck AH
雌激素受体（ER）和孕激素受体（PR）测试是在乳腺癌的评估进行。虽然ER作为一种预测性生物标志物来识别可能从激素治疗中获益的患者的临床效用已经得到了很好的确立，但PR的附加值还没有得到很好的定义。我们研究的主要目的是评估ER和PR表达模式定义的乳腺癌亚型的分布、检测间重现性和预后意义。我们整合了基因表达微阵列（GEM）和20项已发表研究的临床病理数据，以确定ER/PR亚型（ER+/PR+，ER+/PR-，ER-/PR-，ER-/PR+）的频率（n = 4，111）和检测间重现性（n = 1，752）。为了扩展我们的发现，我们利用了来自护士健康研究（NHS）的患者队列，其ER/PR数据记录在病历中并在组织微阵列上进行评估（n = 2，011）。在这两个数据集中，我们评估了ER和PR表达与生存率的关系。在全基因组分析中，孕激素受体是ER-乳腺癌中变异最小的基因之一。ER-/PR+亚型罕见（约1 - 4%），且无显著重现性（GEM和NHS数据集中的Kappa值分别为0.02和0.06）。绝大多数在病历中被分类为ER-/PR+的患者（GEM和NHS数据集中分别为97%和94%）通过第二种方法重新分类。在GEM数据集中（n = 2，731），孕激素受体mRNA表达与ER+乳腺癌的预后相关（校正P <0.001），但与ER-乳腺癌无关（校正P = 0.21）。PR蛋白表达对GEM或NHS数据集中考虑ER和其他标准临床病理特征的多变量模型没有显著的预后信息。ER-/PR+乳腺癌是不可重复的亚型。PR表达与ER-乳腺癌的预后无关，PR对考虑ER和其他标准临床病理因素的多变量模型没有贡献显著的独立预后信息。鉴于PR在ER+乳腺癌中没有提供临床可操作的信息，这些发现质疑常规PR检测在乳腺癌中的实用性。
Estrogen receptor (ER) and progesterone receptor (PR) testing are performed in the evaluation of breast cancer. While the clinical utility of ER as a predictive biomarker to identify patients likely to benefit from hormonal therapy is well-established, the added value of PR is less well-defined. The primary goals of our study were to assess the distribution, inter-assay reproducibility, and prognostic significance of breast cancer subtypes defined by patterns of ER and PR expression. We integrated gene expression microarray (GEM) and clinico-pathologic data from 20 published studies to determine the frequency (n = 4,111) and inter-assay reproducibility (n = 1,752) of ER/PR subtypes (ER+/PR+, ER+/PR-, ER-/PR-, ER-/PR+). To extend our findings, we utilized a cohort of patients from the Nurses’ Health Study (NHS) with ER/PR data recorded in the medical record and assessed on tissue microarrays (n = 2,011). In both datasets, we assessed the association of ER and PR expression with survival. In a genome-wide analysis, progesterone receptor was among the least variable genes in ER- breast cancer. The ER-/PR+ subtype was rare (approximately 1 to 4%) and showed no significant reproducibility (Kappa = 0.02 and 0.06, in the GEM and NHS datasets, respectively). The vast majority of patients classified as ER-/PR+ in the medical record (97% and 94%, in the GEM and NHS datasets) were re-classified by a second method. In the GEM dataset (n = 2,731), progesterone receptor mRNA expression was associated with prognosis in ER+ breast cancer (adjusted P <0.001), but not in ER- breast cancer (adjusted P = 0.21). PR protein expression did not contribute significant prognostic information to multivariate models considering ER and other standard clinico-pathologic features in the GEM or NHS datasets. ER-/PR+ breast cancer is not a reproducible subtype. PR expression is not associated with prognosis in ER- breast cancer, and PR does not contribute significant independent prognostic information to multivariate models considering ER and other standard clinico-pathologic factors. Given that PR provides no clinically actionable information in ER+ breast cancer, these findings question the utility of routine PR testing in breast cancer.
登录
查看更多内容
影响因子：
4.3
作者：
Beck AH;Knoblauch NW;Hefti MM;Kaplan J;Schnitt SJ;Culhane AC;Schroeder MS;Risch T;Quackenbush J;Haibe-Kains B
通讯作者：
Haibe-Kains B
激素受体状态，肿瘤特征和预后：乳腺癌患者的前瞻性队列。
DOI：
10.1186/bcr1639
发表时间：
2007
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Dunnwald LK;Rossing MA;Li CI
通讯作者：
Li CI
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
168.9
作者：
Davies, C.;Godwin, J.;Gray, R.;Clarke, M.;Darby, S.;McGale, P.;Wang, Y. C.;Peto, R.;Pan, H. C.;Cutter, D.;Taylor, C.;Ingle, J.
通讯作者：
Ingle, J.
影响因子：
45.3
作者：
Rakha, Emad A.;El-Sayed, Maysa E.;Ellis, Ian O.
通讯作者：
Ellis, Ian O.