Breast Cancer Subtypes and the Risk of Local and Regional Relapse
Breast Cancer Subtypes and the Risk of Local and Regional Relapse
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DOI：
10.1200/jco.2009.24.9284
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发表时间：
2010-04-01
影响因子：
45.3
通讯作者：
Kennecke, Hagen
中科院分区：
文献类型：
--
作者：
Voduc, K. David;Cheang, Maggie C. U.;Kennecke, Hagen
目的在一个大型乳腺癌患者队列中确定与每种乳腺癌分子亚型相关的局部和区域复发风险。亚型分配是使用一个有效的六标记免疫组化面板应用于tissue microarrais.Patients和MethodsSemi-quantitative分析雌激素受体（ER），孕激素受体（PR），Ki-67，人表皮生长因子受体2（HER 2），表皮生长因子受体（EGFR），和细胞角蛋白（CK）5/6进行了组织微阵列构建从2，985例早期浸润性乳腺癌患者。患者分为以下类别：管腔A型、管腔B型、管腔-HER 2型、HER 2富集型、基底样或三阴性表型-非基底型。多变量考克斯分析用于确定与内在亚型相关的局部或区域复发的风险，调整标准的临床病理factors.ResultsThe内在分子亚型被成功地确定在2,985肿瘤。中位随访时间为12年，共有325例局部复发和227例区域淋巴结复发。ER或PR阳性，HER 2阴性，Ki-67 < 14%的A型腔肿瘤预后最好，局部或区域复发率最低。对于接受保乳的患者，HER 2富集和基础亚型显示区域复发风险增加，多变量分析显示具有统计学意义。乳房切除术后，管腔B，管腔-HER 2，HER 2-富集，和基础亚型都与局部和区域复发的风险增加的多变量analysis.ConclusionLuminal A肿瘤与局部或区域复发的风险低。使用六标记免疫组化面板对乳腺肿瘤进行分子亚型分型可以识别局部和区域复发风险增加的患者。J Clin Oncol 28：1684-1691. (C)2010年美国临床肿瘤学会
PurposeThe risk of local and regional relapse associated with each breast cancer molecular subtype was determined in a large cohort of patients with breast cancer. Subtype assignment was accomplished using a validated six-marker immunohistochemical panel applied to tissue microarrays.Patients and MethodsSemiquantitative analysis of estrogen receptor (ER), progesterone receptor (PR), Ki-67, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and cytokeratin (CK) 5/6 was performed on tissue microarrays constructed from 2,985 patients with early invasive breast cancer. Patients were classified into the following categories: luminal A, luminal B, luminal-HER2, HER2 enriched, basal-like, or triple-negative phenotype-nonbasal. Multivariable Cox analysis was used to determine the risk of local or regional relapse associated the intrinsic subtypes, adjusting for standard clinicopathologic factors.ResultsThe intrinsic molecular subtype was successfully determined in 2,985 tumors. The median follow-up time was 12 years, and there have been a total of 325 local recurrences and 227 regional lymph node recurrences. Luminal A tumors (ER or PR positive, HER2 negative, Ki-67 < 14%) had the best prognosis and the lowest rate of local or regional relapse. For patients undergoing breast conservation, HER2-enriched and basal subtypes demonstrated an increased risk of regional recurrence, and this was statistically significant on multivariable analysis. After mastectomy, luminal B, luminal-HER2, HER2-enriched, and basal subtypes were all associated with an increased risk of local and regional relapse on multivariable analysis.ConclusionLuminal A tumors are associated with a low risk of local or regional recurrence. Molecular subtyping of breast tumors using a six-marker immunohistochemical panel can identify patients at increased risk of local and regional recurrence. J Clin Oncol 28: 1684-1691. (C) 2010 by American Society of Clinical Oncology