High prevalence of HER-2/neu and p53 overexpression in inflammatory breast cancer.
High prevalence of HER-2/neu and p53 overexpression in inflammatory breast cancer.
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DOI：
10.2325/jbcs.13.172
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Hatake, Kiyohiko
中科院分区：
文献类型：
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作者：
Sawaki, Masataka;Ito, Yoshinori;Hatake, Kiyohiko
背景：炎性乳腺癌（IBC）是乳腺癌中最具侵袭性的形式之一。虽然通过联合治疗，IBC患者的生存率已大大提高，但IBC女性患者的生存率仍较低。我们总结了涉及IBC患者的单中心经验。我们的目标是澄清HER-2/neu和p53在IBC的分子改变，并探讨预后factors.METHODS：1990年1月至2000年12月，57例IBC患者被转介到日本癌症研究基金会癌症研究所医院。我院原发性乳腺癌中IBC的发生率为1.0%（57/5,757）。46例符合Haagensen炎性乳腺癌标准的患者进行了评价。所有患者均经活检证实为癌，但转诊时无远处转移。诊断IBC的中位年龄为51.8岁（范围为28至70岁）。所有患者均接受了乳房切除术。术前或术后进行化疗。3年和5年生存率分别为56.5%和40.7%。HER-2/neu和p53蛋白的表达通过免疫组织化学（IHC）染色的薄石蜡包埋切片的原发tumors.Results：46例患者中，23例（50.0%）与HER-2/neu检测阳性的肿瘤表现出比那些与阴性肿瘤稍差，但无论是总生存期（OS）或无病生存期（DFS）的差异不显着。在46例患者中，19例（41.3%）肿瘤p53阳性患者的表现略好于肿瘤阴性患者，OS或DFS无显著差异。少于10例病理累及腋窝淋巴结的患者表现出明显更好的OS和DFS。结论：HER-2/neu和p53蛋白过表达在炎性乳腺癌中不是显著的预后因素。然而，HER-2/neu的发病率增加和IBC的不良结局可能具有临床意义，这表明需要针对HER-2/neu的抗体治疗的临床试验。此外，p53的高患病率可能有助于确定化疗的具体用途。
BACKGROUND: Inflammatory breast cancer (IBC) is one of the most aggressive forms of breast cancer. Although the survival of patients with IBC has been greatly improved by the use of combined treatment modalities, women with IBC still have lower survival rates. We have summarized a single-center experience involving IBC patients. Our objectives are to clarify molecular alterations of HER-2/neu and p53 in IBC and to investigate the prognostic factors.METHODS: Between January 1990 and December 2000, 57 patients with IBC were referred to the Cancer Institute Hospital of the Japanese Foundation for Cancer Research. The incidence of IBC among primary breast cancers was 1.0% (57/5,757) in our hospital. Forty-six patients meeting Haagensen's criteria for inflammatory breast carcinoma were evaluated. All patients had biopsy-proven carcinomas but no distant metastases at referral. The median age at diagnosis for IBC was 51.8 (range, 28 to 70). All patients underwent a mastectomy. Chemotherapy was performed pre- or post-operatively. Three-year and 5-year survival rates were 56.5%, and 40.7%, respectively. Expressions of HER-2/neu and the p53 protein were determined retrospectively by immunohistochemical (IHC) staining of thin paraffin-embedded sections of primary tumors.RESULTS: Of 46 patients, 23 (50.0%) with tumors testing positive for HER-2/neu fared somewhat worse than those with negative tumors, but the differences were not significant for either overall survival (OS) or disease-free survival (DFS). Of 46 patients, 19 (41.3%) whose tumors were positive for p53 fared somewhat better than patients with negative tumors, with no significant differences in either OS or DFS. Patients presenting with less than ten pathologically involved axillary lymph nodes showed significantly better OS and DFS.CONCLUSIONS: Overexpression of HER-2/neu and the p53 protein were not significant prognostic factors in inflammatory breast cancer. However, the increased incidence of HER-2/neu and the poor outcome of IBC may be of clinical interest, suggesting the need for clinical trials of antibody therapy targeted to HER-2/neu. Moreover, a high prevalence of p53 may be useful in determining the specific use of chemotherapy.