转移性三阴性乳腺癌原发灶及转移灶ER、PR、HER2、Ki-67表达差异及与预后的关系  

Differences in estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 expressions between primary sites and metastatic sites in metastatic triple-negative breast cancer

作　　者：周娜 贺艳玲 王倩 杨聪颖 陈昊 Zhou Na;He Yanling;Wang Qian;Yang Congying;Chen Hao(Department of Pathology,Lianyungang Hospital Affiliated to Xuzhou Medical University,Lianyungang 222000,China)

机构地区：[1]徐州医科大学附属连云港医院病理科,连云港222000

出　　处：《肿瘤研究与临床》2024年第8期583-589,共7页Cancer Research and Clinic

摘　　要：目的探讨雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)及Ki-67在转移性三阴性乳腺癌(TNBC)患者原发灶与转移灶中的表达差异及其对患者预后的影响。方法回顾性队列研究。收集2018年9月至2023年9月徐州医科大学附属连云港医院确诊的108例转移性TNBC患者的临床病理资料。局部转移部位包括同侧腋窝淋巴结和同侧胸壁,远处转移部位包括对侧腋窝淋巴结、对侧胸壁、双侧锁骨上淋巴结、颈部淋巴结、骨和内脏。通过免疫组织化学(IHC)和(或)荧光原位杂交确定转移灶为TNBC。分析全部患者及局部转移、远处转移患者原发灶与转移灶间ER、PR、HER2及Ki-67表达的异质性(表达不一致包括转移灶较原发灶表达丢失和表达获得)。采用Kaplan-Meier法分析患者无病生存(DFS),组间比较采用log-rank检验。结果患者均为女性,年龄(55±10)岁;局部转移51例,远处转移57例。转移灶中ER、PR均无阳性,原发灶中ER、PR阳性患者分别占28.7%(31/108)、21.3%(23/108),转移灶和原发灶间ER或PR阳性患者比例差异均有统计学意义(均P<0.001);转移灶和原发灶间HER2[阳性:0(0/108)比4.6%(5/108),低表达:50.0%(54/108)比45.4%(49/108),阴性:50.0%(54/108)比50.0%(54/108)]、Ki-67[高表达86.1%(93/108)比91.7%(99/108)]不同表达状态患者比例差异均无统计学意义(均P>0.05)。转移灶与原发灶ER、PR表达不一致患者比例分别为28.7%(31/108)和21.3%(23/108),且均为转移灶表达丢失;转移灶与原发灶HER2表达不一致患者比例为42.6%(46/108)[转移灶表达丢失占22.2%(24/108),表达获得占20.4%(22/108)],转移灶与原发灶Ki-67表达不一致患者比例为11.1%(12/108)[转移灶表达丢失占8.3%(9/108),表达获得占2.8%(3/108)]。远处转移灶与原发灶间ER[45.6%(26/57)比9.8%(5/51)]、PR[36.8%(21/57)比3.9%(2/51)]、Ki-67[17.5%(10/57)比3.9%(2/51)]表达不一致患者比例均高于局部转移灶与原发灶表达不一致患者�ObjectiveTo investigate the differences in estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER2)and Ki-67 expressions between metastatic sites and primary sites in metastatic triple-negative breast cancer(TNBC)patients and to analyze their effects on the prognosis of patients.MethodsA retrospective cohort study was conducted.The clinicopathological data of 108 patients diagnosed with metastatic TNBC in Lianyungang Hospital Affiliated to Xuzhou Medical University from September 2018 to September 2023 were collected.Local metastatic sites included ipsilateral axillary lymph nodes and chest wall,while distant metastatic sites encompassed contralateral axillary lymph nodes and chest wall,bilateral supraclavicular lymph nodes,cervical lymph nodes,bone and viscera.The metastatic sites were identified as metastatic TNBC by using immunohistochemistry(IHC)and/or fluorescence in situ hybridization.The heterogeneity in ER,PR,HER2,and Ki-67 expression between primary sites and metastatic sites in all patients and those with local and distant metastases was analyzed,and the heterogeneity was defined as the inconsistency in the expression of markers including loss and gain expressions between primary sites and metastatic sites.The Kaplan-Meier method was used to analyze disease-free survival(DFS),and log-rank test was used for comparison among groups.ResultsAll patients were female,with an average age of(55±10)years;51 cases had local metastases,and 57 cases had distant metastases.In metastatic sites,no ER and PR positivity were observed;in primary sites,28.7%(31/108)of patients were ER positive and 21.3%(23/108)of patients were PR positive,and there were statistically significant differences in the proportion of patients with ER or PR positive between primary sites and metastatic sites(all P<0.001).There were no statistically significant differences in the proportions of patients with different expression status including HER2[positive:0(0/108)vs.4.6%(5/108),low expression:50.0%(54/10

关 键 词：三阴性乳腺肿瘤 肿瘤转移 受体 雌激素 受体 孕酮 人表皮生长因子受体2 KI-67抗原 无病生存 

分 类 号：R737.9[医药卫生—肿瘤]