乳腺癌原发及转移灶受体表达差异及其对生存影响的研究  

Study on the discrepancy in expression of receptor in primary and metastatic lesions in breast cancer

作　　者：袁学东[1] 杨国玉[1] 张建英[1] 韩磊[2] 

机构地区：[1]首都医科大学全科医学与继续教育学院延庆县医院肿瘤科,北京102100 [2]北京市大兴区人民医院肿瘤内科,北京102600

出　　处：《临床和实验医学杂志》2017年第10期1019-1022,共4页Journal of Clinical and Experimental Medicine

基　　金：首都医学发展科研基金资助项目(编号2007-1049)

摘　　要：目的确定和比较在原发性乳腺癌和转移灶中雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子2(HER2)表达状态的差异。方法纳入46例同时具备原发灶和转移灶病理报告或有针吸活检标本的患者。对活检标本进行免疫组化重新染色确定受体状态(如果之前的病理报告中未报告),由2名独立的病理学家进行再检测。观察原发灶和转移灶ER、PR和HER2的受体表达状态的不一致率,及由此造成的总生存期差异。结果 ER、PR和HER2的受体表达状态在原发灶和转移灶的不一致率分别为19.6%、44.4%和12.8%。在总生存期方面,不存在由于原发灶和转移灶受体表达状态不同所产生的统计学差异(P>0.05)。结论本研究证明ER、PR和HER2的受体表达状态在原发灶和转移灶的不一致率分别为19.6%、44.4%和12.8%。为了检测转移灶的受体状态所进行的重新活检和IHC可能会改变复查/进展的乳腺癌患者的治疗策略。Objective To determine and compare the difference in expression status of estrogen receptor（ ER）,progesterone receptor（ PR） and human epidermal growth factor receptor-2（ HER2） in primary breast cancer and metastatic lesions. Methods 46 patients with biopsy reports or available samples of the primary foci of tumor and distant metastases were included in the final analysis. Biopsy samples were re-stained by using immunohistochemical methods to determine the status of receptor（ if did not recorded in previous reports） and re-examined by 2independent pathologists. The expression of ER,PR and HER2 receptors in primary and metastatic lesions,and the difference of the total survival were observed. Results The discordance rates for receptor expression status of primary tumor and distant metastases for ER,PR,and HER2 were19. 6%,44. 4% and 12. 8%,respectively. There was no statistically significant difference in overall survival stage due to discordance in receptor expression between primary tumor and metastatic sites（ P〉0. 05） had been found,although a tendency toward worse survival time was observed in patients with discrepancy in HER2 expression. Conclusion This study showed the receptor discordance rates of expression between primary and metastatic breast cancer sites in ER,PR,and HER2 receptors were 19. 6,44. 4 and 12. 8%,respectively. Re-biopsy and IHC for evaluation of metastatic sites for receptor status may change decision of treatment in patients with relapsed/progressed breast cancer.

关 键 词：乳腺癌 原发灶 转移灶 雌激素受体 孕激素受体 人表皮生长因子2 

分 类 号：R737.9[医药卫生—肿瘤]