Poor hormone receptor expression in East African breast cancer: Evidence of a biologically different disease?
Poor hormone receptor expression in East African breast cancer: Evidence of a biologically different disease?
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DOI：
10.1245/s10434-008-9900-7
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发表时间：
2008-07-01
影响因子：
3.7
通讯作者：
Houssami, N.
中科院分区：
文献类型：
--
作者：
Bird, P. A.;Hill, A. G.;Houssami, N.
背景：很少有研究检查非洲人乳腺癌激素受体的表达。我们在该地区最大的前瞻性研究中报告了东非人乳腺癌的激素受体概况。方法：纳入了 Kijabe 一家医院（2001-2007 年）的连续乳腺癌报告。收集人口统计、临床和测试数据。 ER/PR 和 Her2 检测基于免疫组织化学 (IHC)。结果：共有 129 名受试者（中位年龄 47 岁），大多数患有浸润性导管癌和局部晚期疾病和/或转移。 120 例患者进行了 ER/PR 检测：24% 为 ER 阳性肿瘤，34% 为 ER 和/或 PR 阳性肿瘤，10% 为 ER 阴性但 PR 阳性肿瘤，66% 为 ER 和 PR 阴性。 ER/PR 阳性与分期无关（P = 0.28），并且与年龄、产次、绝经状态或淋巴结转移无关。肿瘤分级的增加与 PR 表达相关（P = 0.02），随着组织学分级的增加，PR 阳性肿瘤的频率降低；有微弱的证据表明等级和 ER 表达之间存在关联（P = 0.06）。在测试的病例中，26.5% 过度表达 Her2。结论：Kijabe 乳腺癌是一种晚期疾病，主要由低分化癌症组成，这些癌症不太可能对激素敏感（在疾病的所有阶段）。对所有乳腺癌患者进行 ER/PR 检测应作为全球癌症控制的优先事项予以支持。需要国际和非洲间的研究合作，以便对非洲土著人的肿瘤进行基因详细分析，以评估乳腺癌生物学中可能存在的种族异质性。
Background: Few studies have examined breast cancer hormone receptor expression in Africans. We report on the hormone receptor profile of breast cancer in East Africans in the largest prospective study for this region.Methods: Consecutive breast cancer presentations to a hospital in Kijabe (2001-2007) were included. Demographic, clinical, and test data were collected. ER/PR and Her2 testing was based on immunohistochemistry (IHC).Results: There were 129 subjects (median 47 years), most had invasive ductal cancer and locally advanced disease and/or metastases. ER/PR testing was done in 120: 24% had ER-positive tumours, 34% were ER- and/or PR-positive, 10% were ER-negative but PR-positive tumours, and 66% were negative for ER and PR. ER/PR positivity was not associated with stage (P = 0.28) and was not related to age, parity, menopausal status, or node metastases. Increasing tumour grade was associated with PR expression (P = 0.02) with decreasing frequency of PR positive tumours as histological grade increased; there was weak evidence of an association between grade and ER expression (P = 0.06). Of cases tested, 26.5% overexpressed Her2.Conclusions: Breast cancer in Kijabe is an advanced-stage disease, comprised mainly of poorly differentiated cancers that are less likely to be hormone sensitive (across all stages of disease). ER/PR testing of all those affected by breast cancer should be supported as a global priority in cancer control. International and inter-African research collaborations are needed to allow genetic detailing of tumours in indigenous Africans to assess possible racial heterogeneity in the biology of breast cancer.