Expression of HER2neu in Ductal Carcinoma in situ is Associated with Local Recurrence
Expression of HER2neu in Ductal Carcinoma in situ is Associated with Local Recurrence
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DOI：
10.1016/j.clon.2011.09.008
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发表时间：
2012-04-01
影响因子：
3.4
通讯作者：
Rakovitch, E.
中科院分区：
文献类型：
--
作者：
Han, K.;Nofech-Mozes, S.;Rakovitch, E.
目的：确定导管原位癌(DCIS)局部切除后复发的风险仍然是一个挑战。基于雌激素受体(ER)、孕激素受体(PR)和HER2Neu免疫组织化学染色的分子图谱改善了浸润性乳腺癌的风险预测，但很少有研究评估DCIS的分子分类是否预测局部复发。材料与方法：回顾1987-2000年间收治的DCIS患者的临床资料，进行ER、PR和HER2Neu的病理复习和免疫组织化学染色，并将病例分为四种分子表型：管腔A(ER+和/或PR+，HER2Neu-)，管腔B(ER+和/或PR+，HER2Neu+)，HER2Neu亚型(ER-，PR-，HER2Neu+)，三重阴性(ER-，PR-，HER2Neu-)。结果：共纳入180例DCIS患者，其中管腔A型113例，管腔B型25例，HER2Neu型29例，三阴性13例。中位随访期为8.7年。我们观察到管腔B(40%)和HER2 Neu型(38%)DCIS的局部复发率高于管腔A(21%)和三阴性(15%)DCIS。多因素分析显示，HER2Neu过度表达与局部复发风险增加相关(危险比=1.98，95%可信区间：1.11，3.53，P=0.02)。结论：HER2Neu表达是DCIS局部复发的重要预测因素，而管腔A表型和三重阴性表型与局部复发风险相对较低。(C)2011年皇家放射科医师学会。爱思唯尔有限公司出版。保留所有权利。
Aims: Determination of the risk of recurrence after local excision of ductal carcinoma in situ (DCIS) remains a challenge. Molecular profiling based on immunohistochemical staining to oestrogen receptor (ER), progesterone receptor (PR) and HER2neu improved risk prediction in invasive breast cancer, but few studies have evaluated if molecular classification of DCIS predicts local recurrence. We evaluated the expression of ER, PR and HER2neu in DCIS to determine if molecular classification predicts local recurrence after breast-conserving therapy for DCIS.Materials and methods: We reviewed the records of patients with DCIS treated between 1987 and 2000, carried out a pathology review and immunohistochemical staining for ER, PR and HER2neu and categorised cases into four molecular phenotypes [luminal A (ER+ and/or PR+, HER2neu-), luminal B (ER+ and/or PR+, HER2neu+), HER2neu subtype (ER-, PR-, HER2neu+), triple negative (ER-, PR-, HER2neu-)]. We evaluated the association between the molecular subtype and the development of local recurrence.Results: In total, 180 cases of DCIS were included in the study (luminal A, n = 113; luminal B, n = 25; HER2neu type, n = 29; triple negative, n = 13). The median follow-up time was 8.7 years. We observed higher rates of local recurrence among luminal B (40%) and HER2neu type (38%) DCIS compared with luminal A (21%) and triple negative (15%) DCIS. On multivariable analysis, HER2neu overexpression was associated with an increased risk of local recurrence (hazard ratio = 1.98; 95% confidence interval: 1.11, 3.53, P = 0.02).Conclusion: HER2neu expression in DCIS is a significant predictor of local recurrence, whereas luminal A and triple negative phenotypes are associated with relatively low risks of local recurrence. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.