Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival.
Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival.
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DOI：
10.1186/bcr1636
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Lakhani SR
中科院分区：
文献类型：
--
作者：
Fulford LG;Reis-Filho JS;Ryder K;Jones C;Gillett CE;Hanby A;Easton D;Lakhani SR
细胞角蛋白（CK）14是在正常肌上皮/基底细胞中表达的几种标志物之一，也在一定比例的乳腺癌中表达。以前的研究表明，这种“基础”标志物的表达预测不同的生物学行为，与其他癌症相比，肺和脑转移更频繁，预后更差。我们对443例III级浸润性导管癌进行了CK 14免疫组化，并进行了长期的临床随访（平均116个月），我们将CK 14免疫阳性（基底样表型）与临床病理标准相关联。443例肿瘤中有88例（20%）显示CK 14表达。与CK 14阴性病例相比，CK 14阳性肿瘤更可能是雌激素受体阴性（p < 0.0001）和腋窝淋巴结阴性（p = 0.001）。CK 14阳性病例发生骨和肝转移较少（风险比[HR]分别为0.49，p = 0.01和0.53，p = 0.035），但脑转移更频繁（HR 1.92，p = 0.051）。在无转移性疾病的患者中，CK 14阳性病例的无病生存率显著优于CK 14阴性病例（HR 0.65，p = 0.005）。然而，在转移性疾病患者中，CK 14阳性与预后较差相关（HR 1.84，p = 0.001）。CK 14阳性和阴性患者的5年总生存率相似（分别为60%和59%），但CK 14阳性患者的长期生存率更好（HR 0.69，p = 0.02）。这些结果表明，基底细胞样肿瘤的生物学行为与其他肿瘤不同，具有不同的转移扩散模式。与其他III级肿瘤相比，基底细胞样肿瘤似乎具有相对较好的长期生存率，但转移后的生存率较差。
Cytokeratin (CK) 14, one of several markers expressed in normal myoepithelial/basal cells, is also expressed in a proportion of breast carcinomas. Previous studies have suggested that expression of such 'basal' markers predicts different biological behaviour, with more frequent lung and brain metastases and poorer prognosis than other carcinomas. We performed CK14 immunohistochemistry on 443 grade III invasive ductal carcinomas with extended clinical follow-up (mean 116 months), and we correlated CK14 immunopositivity (basal-like phenotype) with clinicopathological criteria. Eighty-eight of 443 (20%) tumours showed CK14 expression. CK14-positive tumours were more likely to be oestrogen receptor-negative (p < 0.0001) and axillary node-negative (p = 0.001) than were CK14-negative cases. CK14-positive cases developed less bone and liver metastases (hazard ratio [HR] 0.49, p = 0.01, and HR 0.53, p = 0.035, respectively) but more frequent brain metastases (HR 1.92, p = 0.051). In patients without metastatic disease, disease-free survival in CK14-positive cases was significantly better than in CK14-negative cases (HR 0.65, p = 0.005). In patients with metastatic disease, however, CK14 positivity was associated with a poorer prognosis (HR 1.84, p = 0.001). The overall survival in CK14-positive and -negative patients was similar at 5 years (60% and 59%, respectively), but the long-term survival was better in CK14-positive patients (HR 0.69, p = 0.02). These results demonstrate that basal-like tumours differ in their biological behaviour from other tumours, with a distinct pattern of metastatic spread. Compared to other grade III tumours, basal-like tumours appear to have a relatively good long-term survival but survival after metastases is poor.
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影响因子：
7.3
作者：
Gillett, CE;Miles, DW;Hanby, AM
通讯作者：
Hanby, AM
影响因子：
6.4
作者：
Fulford, L. G.;Easton, D. F.;Hanby, A.
通讯作者：
Hanby, A.
影响因子：
10.3
作者：
Lakhani, SR;Jacquemier, J;Easton, DF
通讯作者：
Easton, DF
影响因子：
7.3
作者：
El-Rehim, DMA;Pinder, SE;Ellis, IO
通讯作者：
Ellis, IO
影响因子：
7.5
作者：
Livasy, CA;Karaca, G;Perou, CM
通讯作者：
Perou, CM