Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer
Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer
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DOI：
10.1093/annonc/mdp263
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发表时间：
2009-12-01
影响因子：
50.5
通讯作者：
Gonzalez-Angulo, A. M.
中科院分区：
文献类型：
--
作者：
Liedtke, C.;Broglio, K.;Gonzalez-Angulo, A. M.
方法：对789例复发性乳腺癌患者进行研究。通过免疫组织化学（IHC）和/或FISH确定ER、PR和HER 2状态。ER、PR和HER 2的重复标记分别为28.9%、27.6%和70.0%。原发性和复发性肿瘤被分类为三重受体阴性乳腺癌（TNBC）或受体阳性乳腺癌（RPBC，即表达至少一种受体）。结果：ER、PR和HER 2的不一致性分别为18.4%、40.3%和13.6%。RPBC一致的患者复发后生存率（PRS）明显优于不一致的患者;受体状态不一致的患者与TNBC一致的患者生存率相似。ER和PR的IHC评分显示原发性和复发性肿瘤之间的一致性较弱。HER 2-FISH分数的一致性是higher.Conclusions：原发性和复发性肿瘤之间的定量激素受体测量的一致性是适度一致的测量方法，特别是IHC的次优再现性。不一致病例的生存率很低，可能是由于靶向治疗的不当使用。然而，不能完全排除临床表型的生物学变化。
Methods: A total of 789 patients with recurrent breast cancer were studied. ER, PR, and HER2 status were determined by immunohistochemistry (IHC) and/or FISH. Repeat markers for ER, PR, and HER2 were available in 28.9%, 27.6%, and 70.0%, respectively. Primary and recurrent tumors were classified as triple receptor-negative breast cancer (TNBC) or receptor-positive breast cancer (RPBC, i.e. expressing at least one receptor). Discordance was correlated with clinical/pathological parameters.Results: Discordance for ER, PR, and HER2 was 18.4%, 40.3%, and 13.6%, respectively. Patients with concordant RPBC had significantly better post-recurrence survival (PRS) than discordant cases; patients with discordant receptor status had similarly unfavorable survival as patients with concordant TNBC. IHC scores for ER and PR showed weak concordance between primary and recurrent tumors. Concordance of HER2-FISH scores was higher.Conclusions: Concordance of quantitative hormone receptor measurements between primary and recurrent tumors is modest consistent with suboptimal reproducibility of measurement methods, particularly for IHC. Discordant cases have poor survival probably due to inappropriate use of targeted therapies. However, biological change in clinical phenotype cannot be completely excluded.