Comparison of Oncotype DX and Mammostrat risk estimations and correlations with histologic tumor features in low-grade, estrogen receptor-positive invasive breast carcinomas
Comparison of Oncotype DX and Mammostrat risk estimations and correlations with histologic tumor features in low-grade, estrogen receptor-positive invasive breast carcinomas
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DOI：
10.1038/modpathol.2013.88
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发表时间：
2013-11-01
期刊：
影响因子：
7.5
通讯作者：
Laronga, Christine
中科院分区：
文献类型：
--
作者：
Acs, Geza;Kiluk, John;Laronga, Christine
已经开发了几种分子检测来评估远处复发的风险，并帮助临床决策早期乳腺癌患者的辅助化疗。Oncotype DX（一种21基因表达谱）和Mammostrat（一种基于免疫化学的检测方法）均经验证可将患者分为具有低、中和高远处复发风险的组。然而，它们还没有进行头对头比较，关于它们与临床病理肿瘤特征的相关性的数据很少。在这项研究中，我们比较了106例低级别雌激素受体（ER）阳性乳腺癌的临床病理学肿瘤特征与Oncotype DX和Mammostrat的风险估计。对全细胞角蛋白和Ki-67进行双重免疫组织化学染色，以评估癌症与基质/炎性细胞中的细胞增殖。通过Oncotype DX而不是通过Mammostrat显示中等/高风险的肿瘤显示基质细胞结构增加、炎性细胞的存在和基质/炎性细胞增殖增加。与两种检测均显示低风险的一致病例相比，显示Oncotype DX中/高风险但Mammostrat低风险的不一致病例与基质细胞构成增加、炎性细胞存在和基质/炎性细胞增殖增加相关。我们的研究结果表明，低级别ER阳性乳腺癌与增加间质/炎性细胞增殖可能会显示出明显增加的风险，远处复发的评估Oncotype DX，其中使用的RNA提取的混合物中的肿瘤和间质/炎性细胞的测定。Mammostrat仅检查癌细胞，可以更好地估计低级别乳腺癌亚组中可能的肿瘤行为。
Several molecular tests have been developed to estimate risk of distant recurrence and help clinical decision-making regarding adjuvant chemotherapy in patients with early stage breast carcinoma. Both Oncotype DX, a 21-gene expression profile, and Mammostrat, an immunohistochemistry-based assay, are validated to stratify patients into groups with low, intermediate and high risk of distant recurrence. However, they have not been compared head-to-head and little data are available regarding their correlation with clinicopathologic tumor features. In this study, we compared the clinicopathologic tumor features with risk estimations by Oncotype DX and Mammostrat in 106 low-grade estrogen receptor (ER)-positive breast carcinomas. Double immunohistochemical stain for pancytokeratin and Ki-67 was performed to assess cell proliferation in cancer vs stromal/inflammatory cells. Tumors showing intermediate/high risk by Oncotype DX, but not by Mammostrat, showed increased stromal cellularity, presence of inflammatory cells and increased proliferation in stromal/inflammatory cells. Discrepant cases showing intermediate/high risk by Oncotype DX but low risk by Mammostrat were associated with increased stromal cellularity, presence of inflammatory cells and increased proliferation in stromal/inflammatory cells, compared with concordant cases showing low risk by both assays. Our results suggest that low-grade ER-positive breast carcinomas with increased stromal/inflammatory cell proliferation may show an apparent increased risk of distant recurrence as assessed by Oncotype DX, which uses RNA extracted from a mixture of tumor and stromal/inflammatory cells in the assay. Mammostrat, which examines cancer cells only, may provide a better estimation of likely tumor behavior in a subgroup of low-grade breast carcinomas.