乳腺癌原发灶与转移灶内ER、PR、Her-2表达的差异及其对治疗的影响  

Discordant expression of estrogen receptor( ER),progestin receptor( PR) and Her-2 between primary and metastatic breast cancer and effect on clinical treatment

作　　者：杨英[1] 陈峰 倪国英[1] 丁罡 Yang Ying;Chen Feng;Ni Guoying;Ding Gang(Department of Oncology,Xinhua Hospital Affiliated to Shanghai Jiaotong University of Medicine,Shanghai 202150,China;Department of Pathology,Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiaotong University of Medicine,Shanghai 202150,China;Department of Oncology,Shanghai International Medical Center,Shanghai 200120,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院肿瘤科,上海202150 [2]上海交通大学医学院附属新华医院崇明分院病理科,上海202150 [3]上海国际医学中心肿瘤科,上海200120

出　　处：《现代肿瘤医学》2020年第4期592-595,共4页Journal of Modern Oncology

基　　金：上海市崇明区科研攻关计划项目(编号:CKY2013-35)

摘　　要：目的:探索ER、PR、Her-2在乳腺癌原发灶及转移灶内表达的差异,及其对治疗的影响。方法:用IHC方法对44例有淋巴结或者远处转移灶或者局部复发的乳腺癌患者原发灶及转移灶标本配对进行ER、PR、Her-2检测,然后分别计算二者表型的表达率以及变化率,并根据原发灶及转移灶ER、PR、Her-2表达的情况调整治疗方案用于临床治疗。结果:44例乳腺癌组织的ER、PR、Her-2在原发灶的阳性表达率分别为68.2%、61.4%、18.2%,而在转移灶中的阳性表达率分别为65.9%、63.6%、9.1%,三者在原发灶及转移灶中的阳性表达率差异均无显著统计学意义。ER、PR、Her-2在原发灶与转移灶间的总变化率分别为:25.0%(11例)、27.3%(12例)、9.1%(4例)。44例乳腺癌患者中,内分泌治疗增加12例,占比27.3%。结论:由于ER、PR、Her-2在乳腺癌原发灶与转移灶间的表达存在一定的差异,因此,对复发转移灶的受体再检查是必要的,并根据原发灶及转移灶的受体表达情况综合考虑治疗方案。To explore discordant expression of estrogen receptor(ER),progestin receptor(PR)and Her-2 between primary and metastatic breast cancer and to detect effect on clinical treatment.Methods:44 cases of breast cancer with lymph nodes metastasis or distant metastasis or local relapse were detected expression of ER,PR and Her-2 by immunohistochemistry assay.Then to object expression rates and gifting rates of ER,PR and Her-2 in primary and metastatic sites of breast cancer.And treatment of patient was changed in clinic due to the expression gifts of ER,PR and Her-2 in primary and metastatic breast cancer.Results:Positive rates of ER,PR and Her-2 were respectively 68.2%,61.4%,18.2%in primary sites of breast cancer,and 65.9%,63.6%,9.1%in metastatic sites.Positive rates of ER,PR and Her-2 were no significant different between primary and metastatic sites.Total discordant rates of ER,PR and Her-2 were 25.0%(11 cases),27.3%(12 cases),9.1%(4 cases)respectively.Endocrine treatment was added in 12 patients(12/44,about 27.3%).Conclusion:ER,PR and Her-2 were discordant between primary and metastatic breast cancer,so to detect ER,PR and Her-2 of metastatic sites again was necessary,and design clinic treatment according to expression of receptors in primary and metastatic breast cancer.

关 键 词：乳腺癌 原发灶 转移灶 ER PR HER-2 差异表达 

分 类 号：R737.9[医药卫生—肿瘤]