Clinical significance of basal-like subtype in triple-negative breast cancer
Clinical significance of basal-like subtype in triple-negative breast cancer
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DOI：
10.1007/s12282-009-0150-8
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发表时间：
2009-10-01
期刊：
影响因子：
4
通讯作者：
Iwase, Hirotaka
中科院分区：
文献类型：
--
作者：
Yamamoto, Yutaka;Ibusuki, Mutsuko;Iwase, Hirotaka
背景三阴性(TN)乳腺癌尚无临床有用的靶分子，即雌激素受体(ER)阴性、孕激素受体(PGR)阴性、人表皮生长因子受体-2(HER2)阴性表型，预后较差。三阴性癌包括两种亚型：基底样癌和非基底样癌。方法采用免疫组织化学方法检测三阴性乳腺癌组织中细胞角蛋白(CK)5/6和表皮生长因子受体(EGFR)的表达。基底样亚型定义为CK5/6阳性和/或EGFR阳性，非基底样亚型定义为这两种标志物不表达。结果48例可手术的三阴性乳腺癌中，基底样亚型22例(45.8%)，非基底样亚型26例(54.2%)。基底细胞样亚型与结节状态(P=0.0475)和核级别(P=0.0475)显著相关。基底细胞样亚型与Ki67标记指数(P=0.0118)、c-kit表达(P=0.0335)和Aurora A表达(P=0.0020)显著相关。未发现基底细胞样癌与其他生物标志物之间存在关联。三阴性癌中基底细胞样亚型患者的无瘤生存期(P=0.0049)和总生存期(P=0.0283)均短于非基底细胞样亚型患者。单因素分析未发现独立的预后因素。结论基础标记物可用于将三阴性乳腺癌分为至少两种预后不同的亚型。为了改善基底细胞样亚型三阴性乳腺癌患者的预后，有必要开发一种新的治疗策略。
Background No clinically useful target molecule has been identified for triple-negative (TN) breast cancer, i.e., estrogen receptor (ER)-negative, progesterone receptor (PgR)-negative, human epidermal growth factor receptor-2 (HER2)-negative phenotype, and its prognosis is poor. Triple-negative cancer consists of two subtypes: basal-like and non-basal-like. The aim of this study is to clarify the clinical and biological characteristics of these two subtypes of TN cancer.Methods We examined, by immunohistochemistry, expression of biological markers cytokeratin (CK) 5/6 and epidermal growth factor receptor (EGFR) in triple-negative breast cancer. Basal-like subtype was defined as CK5/6-positive and/or EGFR-positive, and non-basal-like subtype was defined as no expression of these two markers. We studied the correlation between basal-like subtype and several factors related to tumor progression, along with the prognostic value of basal-like subtype and other biological markers in triple-negative cancer.Results In the 48 cases of operable triple-negative breast cancer, basal-like subtype was detected in 22 (45.8%) and non-basal-like subtype in 26 (54.2%). Basal-like subtype was significantly correlated with nodal status (P = 0.0475) and nuclear grade (P = 0.0475). Basal-like subtype was also significantly associated with Ki67 labeling index (P = 0.0118), c-kit expression (P = 0.0335), and aurora A expression (P = 0.0020). No association was detected between basal-like cancer and other biological markers. Patients with basal-like subtype of triple-negative cancer showed shorter disease-free survival (P = 0.0049) and overall survival (P = 0.0283) than patients with non-basal-like subtype. No independent prognostic factors were identified among the prognostic factors obtained from univariate analysis.Conclusions These findings suggest that basal markers can be used to classify triple-negative breast cancer into at least two subtypes with differing prognoses. It is necessary to develop a novel treatment strategy to improve the prognosis of patients with basal-like subtype of triple-negative breast cancer.