Breast cancer subtyping by immunohistochemistry and histological grade outperforms breast cancer intrinsic subtypes in predicting neoadjuvant chemotherapy response.
Breast cancer subtyping by immunohistochemistry and histological grade outperforms breast cancer intrinsic subtypes in predicting neoadjuvant chemotherapy response.
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DOI：
10.1007/s10549-013-2620-0
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发表时间：
2013-07
影响因子：
3.8
通讯作者：
Wesseling, J.
中科院分区：
文献类型：
--
作者：
Lips, E. H.;Mulder, L.;de Ronde, J. J.;Mandjes, I. A. M.;Koolen, B. B.;Wessels, L. F. A.;Rodenhuis, S.;Wesseling, J.
关键词：
内在亚型被广泛接受用于乳腺癌的分类。由于缺乏基因表达数据，已经提出了基于免疫组织化学（IHC）的替代分类。最近的圣加仑共识会议建议使用这种“替代内在亚型”来预测辅助化疗耐药性，这意味着“替代管腔A”乳腺癌应该只接受内分泌治疗。在这项研究中，我们评估了基于基因表达的内在亚型以及替代内在亚型预测新辅助化疗获益的能力。对560例乳腺癌患者的单机构数据进行了审查。247例患者的基因表达数据可用。根据IHC、Ki 67、组织学分级、内分泌反应性和基因表达确定亚型，并与化疗反应和无复发生存率相关。在ER+/HER 2 −肿瘤中，高组织学分级是化疗获益的最佳预测因子，包括pCR（p = 0.004）和无复发生存期（p = 0.002）。基于Ki 67的基因表达和替代内在亚型在ER+/HER 2 −肿瘤中没有预测或预后价值。组织学分级、ER、PR和HER 2是乳腺癌化疗反应的最佳预测因素。我们建议继续按常规使用这些标记。本文的在线版本（doi：10.1007/s10549-013-2620-0）包含补充材料，可供授权用户使用。
Intrinsic subtypes are widely accepted for the classification of breast cancer. Lacking gene expression data, surrogate classifications based on immunohistochemistry (IHC) have been proposed. A recent St. Gallen consensus meeting recommends to use this “surrogate intrinsic subtypes” for predicting adjuvant chemotherapy resistance, implying that “Surrogate Luminal A” breast cancers should only receive endocrine therapy. In this study we assessed both gene expression based intrinsic subtypes as well as surrogate intrinsic subtypes regarding their power to predict neoadjuvant chemotherapy benefit. Single institution data of 560 breast cancer patients were reviewed. Gene expression data was available for 247 patients. Subtypes were determined on the basis of IHC, Ki67, histological grade, endocrine responsiveness, and gene expression, and were correlated with chemotherapy response and recurrence-free survival. In ER+/HER2− tumors, a high histological grade was the best predictor for chemotherapy benefit, both in terms of pCR (p = 0.004) and recurrence-free survival (p = 0.002). The gene expression based and surrogate intrinsic subtype based on Ki67 had no predictive or prognostic value in ER+/HER2− tumors. Histological grade, ER, PR, and HER2 were the best predictive factors for chemotherapy response in breast cancer. We propose to continue the conventional use of these markers. The online version of this article (doi:10.1007/s10549-013-2620-0) contains supplementary material, which is available to authorized users.
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DOI：
10.1073/pnas.0932692100
发表时间：
2003-07-08
影响因子：
11.1
作者：
Sorlie, T;Tibshirani, R;Botstein, D
通讯作者：
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影响因子：
45.3
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影响因子：
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Perou, Charles M.
影响因子：
45.3
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Bernard, Philip S.
影响因子：
45.3
作者：
von Minckwitz, Gunter;Untch, Michael;Loibl, Sibylle
通讯作者：
Loibl, Sibylle