Stability of Estrogen Receptor Status in Breast Carcinoma A Comparison Between Primary and Metastatic Tumors With Regard to Disease Course and Intervening Systemic Therapy
Stability of Estrogen Receptor Status in Breast Carcinoma A Comparison Between Primary and Metastatic Tumors With Regard to Disease Course and Intervening Systemic Therapy
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DOI：
10.1002/cncr.25506
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发表时间：
2011-02-15
期刊：
影响因子：
6.2
通讯作者：
Sneige, Nour
中科院分区：
文献类型：
--
作者：
Gong, Yun;Han, Eric Yulong;Sneige, Nour
背景技术背景：本研究的目的是解决一个持续的争议，是否ER状态的原发性肿瘤在进展到转移过程中保持稳定，并评估疾病过程和先前的全身治疗对ER状态的影响。方法：回顾性分析227例原发肿瘤和配对转移的ER状态已知的乳腺癌患者。比较原发性和转移性肿瘤的ER状态，包括转移部位、两次ER检测之间的间隔以及介入化疗和内分泌治疗。对92个肿瘤对进行ER值的半定量比较。结果：210例（92.5%）患者ER状态符合，其中阳性147例，阴性63例。在17例ER状态不一致的患者（7.5%）中，观察到阴性转阳性（n = 7）和阳性转阴性（n = 10）。ER不一致性与转移部位（局部与远处）、检测间隔时间（≥ 5年）或介入化疗和内分泌治疗无显著相关。ER表达的半定量水平在原发性和转移性肿瘤之间是相似的。在不一致的情况下，测试方法和边际分数的变化是常见的。结论：乳腺癌ER状态在转移过程中一般是稳定的。在某些情况下，分析前和分析变异性可能导致不一致。鉴于ER状态对临床管理的重要性，转移性乳腺癌的ER检测应重复进行，特别是对于临床病程与ER状态不一致的患者。Cancer 2011;117：705-13. (C)2010年美国癌症协会
BACKGROUND: The purposes of this study were to address a persistent controversy as to whether the ER status of a primary tumor remains stable during progression to metastasis and to evaluate the influence of disease course and prior systemic therapy on ER status. METHODS: Breast carcinomas from 227 women with known ER status in both primary tumor and paired metastasis were retrospectively reviewed. ER status was compared between primary and metastatic tumors with respect to metastatic site, interval between two ER assays, and intervening chemotherapy and endocrine therapy. Semiquantitative comparison of ER values was performed for 92 tumor pairs. RESULTS: ER status agreed in 210 (92.5%) patients, including 147 positive and 63 negative. Of the 17 patients (7.5%) with discordant ER status, both negative to positive conversion (n = 7) and positive to negative conversion (n = 10) were observed. ER discordance was not significantly associated with metastatic site (locoregional vs distant), time interval between assays (= 5 years), or intervening chemotherapy and endocrine therapy. Semiquantitative levels of ER expression were similar between primary and metastatic tumors. In discordant cases, variations in testing methods and marginal scores were common. CONCLUSIONS: ER status in breast carcinoma is generally stable during progression to metastasis. Preanalytical and analytical variability may contribute to discordance in some cases. Given the importance of ER status for clinical management, ER testing in metastatic breast carcinoma should be repeated, especially for patients whose clinical courses are not compatible with stated ER status. Cancer 2011;117:705-13. (C) 2010 American Cancer Society