Histological grade as an alternative to the Ki67 labeling index is only available for luminal-type breast cancers
Histological grade as an alternative to the Ki67 labeling index is only available for luminal-type breast cancers
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DOI：
10.1007/s12282-012-0353-2
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发表时间：
2014-01-01
期刊：
影响因子：
4
通讯作者：
Hirata, Satoshi
中科院分区：
文献类型：
--
作者：
Hayashi, Satoshi;Kitada, Masahiro;Hirata, Satoshi
2011年圣加仑共识声明主张，如果没有可靠的Ki67标记指数（Ki67- li）评估，则使用组织学分级（HG）作为乳腺癌（BC）的增殖标志物。然而，在HG2病例中，很难评估肿瘤的侵袭性。259例BC患者被评估HG、Ki67-LI和其他临床病理特征。Ki67-LI的切点使用14%的阈值解释为低和高。诊断时的平均年龄为58.2岁（28-86岁）；64.9%的患者为绝经后。259例患者中ⅰ期151例，ⅱ期78例，ⅲ期29例，ⅳ期1例。免疫组化染色分型分别为：luminal A （LA）型60例（23.2%），luminal B (LB) （HER2-）型37例（14.3%），LB （HER2+）型91例（35.1%），人表皮生长因子受体2 （HER2）型40例（15.4%），三阴性（TN）型31例（12%）。HG分别为1例（89例，34.4%）、2例（117例，45.2%）和3例（53例，20.5%）。高Ki67-LI患者分别为HG1（37.1%）、HG2（56.4%）和HG3（96.2%）。尤其在HG2病例中，高Ki67-LI发生率分别为0%的LA型、100%的LB （HER2-）型、71.2%的LB （HER2+）型、68.8%的HER2型和40.0%的TN型。Ki67-LI平均为6.0 +/- A 3.8 （LA型）、31.4 +/- A 15.7 （LB （HER2-）型）、20.2 +/- A 14.8 （LB （HER2+）型）、32.7 +/- A 21.9 （HER2型）和55.7 +/- A 32.2 （TN型）。所有la型和66.7% LB （HER2+）型患者均为低Ki67-LI。我们的研究表明，所有la型病例和大多数LB （HER2+）型病例的HG1是低增殖的。然而，HG在LB （HER2-）、HER2和TN型病例中并不能提供足够的信息来估计肿瘤的增殖。除LA和HG1型LB （HER2+）病例外，还需要添加其他增殖工具，如基因表达谱工具和Ki67-LI。
The 2011 St. Gallen Consensus Statement advocated using histological grade (HG) as a proliferation marker of breast cancer (BC) if reliable Ki67 labeling index (Ki67-LI) assessment is not available. However, it has been difficult to evaluate tumor aggressiveness in case of HG2.A total of 259 cases of BC were assessed for HG, Ki67-LI and other clinicopathological features. The cut point for Ki67-LI was interpreted as low and high using a 14 % threshold.The average age at diagnosis was 58.2 years (range 28-86); 64.9 % of the patients were postmenopausal. Of the 259 cases, 151 were stage I, 78 were stage II, 29 were stage III, and 1 was stage IV. The subtypes based on immunohistochemical staining were 60 cases of luminal A (LA) type (23.2 %), 37 cases of luminal B (LB) (HER2-) type (14.3 %), 91 cases of LB (HER2+) type (35.1 %), 40 cases of human epidermal growth factor receptor 2 (HER2) type (15.4 %) and 31 cases of triple negative (TN) type (12 %). HG was 1 (89 cases, 34.4 %), 2 (117 cases, 45.2 %) and 3 (53 cases, 20.5 %). High Ki67-LI cases were observed in HG1 (37.1 %), HG2 (56.4 %) and HG3 (96.2 %). Especially in cases of HG2, high Ki67-LI cases were observed in 0 % of LA type, 100 % of LB (HER2-) type, 71.2 % of LB (HER2+) type, 68.8 % of HER2 type and 40.0 % of TN type. The average Ki67-LI was 6.0 +/- A 3.8 (LA type), 31.4 +/- A 15.7 [LB (HER2-) type], 20.2 +/- A 14.8 [LB (HER2+) type], 32.7 +/- A 21.9 (HER2 type) and 55.7 +/- A 32.2 (TN type). All LA-type cases and 66.7 % of LB (HER2+)-type cases were low Ki67-LI.Our study demonstrates that all LA-type cases and most HG1 of LB (HER2+)-type cases are low proliferative. However, HG was not informative enough for estimating tumor proliferation in cases of LB (HER2-), HER2 and TN types. It is necessary to add other proliferation tools such as the gene expression profiling tool and Ki67-LI except in LA and HG1 of LB (HER2+)-type cases.