Outcomes in young women with breast cancer of triple-negative phenotype: The prognostic significance of CK19 expression
Outcomes in young women with breast cancer of triple-negative phenotype: The prognostic significance of CK19 expression
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DOI：
10.1016/j.ijrobp.2007.05.066
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发表时间：
2008-01-01
影响因子：
7
通讯作者：
Haffty, Bruce G.
中科院分区：
文献类型：
--
作者：
Parikh, Rahul R.;Yang, Qifeng;Haffty, Bruce G.
目的：乳腺癌基底样癌与遗传不稳定和攻击行为有关。在这项研究中，我们评估了接受保守手术和放射治疗 (CS+RT) 治疗的年轻乳腺癌女性的管腔细胞角蛋白标志物 CK-19。 方法：将来自接受 CS+RT 治疗、中位随访时间为 6.25 年的 158 名年轻绝经前女性（范围，2549 岁）的原发肿瘤标本构建成组织微阵列。该阵列对 ER、PR、HER2、CK19 和 p53 进行染色。分子特征与临床病理因素、总体、局部和远处无复发生存率相关。在多变量模型中评估 CK19、其他协变量和结果之间的关联。结果：ER、PR、HER-2/neu、CK19 和 p53 的阳性表达分别为 33.1%、34.5%、10.0%、79.5% 和 20.9%。局部复发 20 例，远处转移 38 例，10 年总生存率、乳腺无复发生存率和远处无复发生存率分别为 79.65%、87.29% 和 67.35%。肿瘤分期和淋巴结状态与远处无复发和总生存率相关。在多变量分析中，CK19阴性是局部生存（RR，3.54；95% CI，1.87-7.65；p < 0.01）、远端生存（RR，1.44；95% CI，0.86-2.70；p = 0.17）和总生存（RR，1.89；95% CI，1.04-3.55；p = 0.17）的不良预测因子。 p = 0.03）。结论：CK19 表达缺失表明部分患者局部复发风险显着较高。远处复发和总生存率也与 CK19 阴性相关。有必要进一步评估年轻乳腺癌女性基底细胞角蛋白和管腔细胞角蛋白的预后意义。 (c) 2008 爱思唯尔公司。
Purpose: Basal-like carcinoma of the breast is associated with genetic instability and aggressive behavior. In this study, we evaluated the luminal cytokeratin marker CK-19 in young women with breast cancer treated with conservative surgery and radiation therapy (CS+RT).Methods: Primary tumor specimens from a cohort of 158 young premenopausal women (range, 2549 years) treated with CS+RT with a median follow-up of 6.25 years were constructed into a tissue microarray. The array was stained for ER, PR, HER2, CK19, and p53. The molecular profiles were correlated with clinical-pathologic factors, overall, local, and distant relapse-free survival. The association between CK19, other co-variables, and outcome was assessed in a multivariate model.Results: Positive expression of ER, PR, HER-2/neu, CK19, and p53 were 33.1%,34.5%,10.0%,79.5%, and 20.9%, respectively. With 20 local relapses and 38 distant metastases, the 10-year overall, breast relapse-free, and distant relapse-free survival were 79.65%, 87.29%, and 67.35%, respectively. Tumor stage and nodal status were associated with distant relapse-free and overall survival. In multivariate analysis, CK19 negativity was a predictor poor local (RR, 3.54; 95% CI, 1.87-7.65;p < 0.01) distant (RR, 1.44; 95% CI, 0.86-2.70;p = 0.17), and overall survival (RR, 1.89;95% CI, 1.04-3.55; p = 0.03).Conclusions: Lack of CK19 expression identifies a subset of patients with a significantly higher risk of local relapse. Distant relapse and overall survival rates also correlated with CK19 negativity. Further evaluation of the prognostic significance of basal and luminal cytokeratins in young women with breast cancer is warranted. (c) 2008 Elsevier Inc.