Metastatic progression of breast cancer: insights from 50 years of autopsies.
Metastatic progression of breast cancer: insights from 50 years of autopsies.
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DOI：
10.1002/path.4288
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发表时间：
2014-01
影响因子：
7.3
通讯作者：
Lakhani, Sunil R.
中科院分区：
文献类型：
--
作者：
Cummings, Margaret C.;Simpson, Peter T.;Reid, Lynne E.;Jayanthan, Janani;Skerman, Joanna;Song, Sarah;Reed, Amy E. McCart;Kutasovic, Jamie R.;Morey, Adrienne L.;Marquart, Louise;O'Rourke, Peter;Lakhani, Sunil R.
对于转移性乳腺癌患者的最佳管理仍然没有明确的指导方针。为了更好地了解其自然史，我们对197例死于乳腺癌的妇女进行了详细的尸检。我们回顾了所有病例的临床、治疗和病理学方面，此外，对55例病例的原发肿瘤和匹配转移灶的病理学特征和生物标志物表达（ER、PgR、HER 2、EGFR、p53、Ki 67、c-Kit、CK AE 1/AE 3）进行了详细评估。通过基于阵列的比较基因组杂交分析了6例原发性肿瘤和多发性转移瘤的基因组##。确定了945个转移性沉积物，中位数为4个/患者。最常见的受累器官为肺/胸膜（80%）、骨（74%）、肝（71%）和非腋窝淋巴结（55%）。主要调查结果包括：（a）有中枢神经系统转移的病人，（p < 0.013）;（B）年轻与肝转移相关（≤ 49岁; p < 0.001）和妇科器官（≤ 49岁; p = 0.001）;（c）原发性肿瘤的手术切除与肝转移相关（p = 0.002）;和（d）ER和PgR在进展期间以非随机方式显示下调，特别是在肺/胸膜（ER; p < 0.001）、肝和骨转移中。基因组分析显示原发肿瘤和转移瘤之间的DNA拷贝数差异（例如2q11.2-q12.1和10q22.2-q22.3的扩增），但同一患者的转移瘤之间的差异很小。总之，CNS与骨转移、年轻女性肝转移和妇科转移的相关性以及手术后肝转移的风险对乳腺癌患者的管理具有重要意义。原发性肿瘤的克隆异质性在发展转移倾向中是重要的，并且进展/定殖期间肿瘤表型的变化突出了对转移性疾病进行采样以获得最佳治疗策略的重要性。© 2013作者。病理学杂志由John Wiley & Sons Ltd代表大不列颠和爱尔兰病理学会出版。
There remain no clear guidelines for the optimal management of patients with metastatic breast cancer. To better understand its natural history, we undertook a detailed examination of 197 autopsies performed on women who died of breast cancer. We reviewed clinical, treatment and pathological aspects of all cases and, additionally, pathological features and biomarker expression (ER, PgR, HER2, EGFR, p53, Ki67, c-Kit, CK AE1/AE3) were assessed in detail for the primary tumour and matched metastases for 55 of the cases. Genomes of the primary tumour and multiple metastases were analysed by array-based comparative genomic hybridization for six cases##. 945 metastatic deposits were identified, with a median of four/patient. The most common organs involved were lung/pleura (80%), bone (74%), liver (71%) and non-axillary lymph nodes (55%). Major findings included: (a) patients with CNS metastases were more likely to have bone metastases (p < 0.013); (b) younger age was associated with metastasis to the liver (≤ 49 years; p < 0.001) and to gynaecological organs (≤ 49 years; p = 0.001); (c) surgical excision of the primary tumour was associated with metastasis to the liver (p = 0.002); and (d) ER and PgR showed down-regulation during progression in a non-random manner, particularly in lung/pleura (ER; p < 0.001), liver and bone metastases. Genomic analysis revealed DNA copy number variation between the primary tumour and metastases (e.g. amplification of 2q11.2–q12.1 and 10q22.2–q22.3) but little variation between metastases from the same patient. In summary, the association of CNS and bone metastases, liver and gynaecological metastases in young women and the risk of liver metastases following surgery have important implications for the management of patients with breast cancer. Clonal heterogeneity of the primary tumour is important in developing metastatic propensity and the change in tumour phenotype during progression/colonization highlights the importance of sampling metastatic disease for optimal treatment strategies. © 2013 The Authors. Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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影响因子：
64.8
作者：
通讯作者：
--
DOI：
10.1097/00000421-199612000-00007
发表时间：
1996-12-01
影响因子：
2.6
作者：
Barista, I;Baltali, E;Firat, D
通讯作者：
Firat, D
影响因子：
8.8
作者：
Demicheli, R;Valagussa, P;Bonadonna, G
通讯作者：
Bonadonna, G
影响因子：
64.8
作者：
Navin N;Kendall J;Troge J;Andrews P;Rodgers L;McIndoo J;Cook K;Stepansky A;Levy D;Esposito D;Muthuswamy L;Krasnitz A;McCombie WR;Hicks J;Wigler M
通讯作者：
Wigler M
影响因子：
50.5
作者：
Slimane, K;Andre, F;Spielmann, M
通讯作者：
Spielmann, M