乳腺癌患者激素受體、人表皮生長因子受體2表達與免疫組織化學分子亞型分析_《華西醫學》

作者：

鄧窈窕 , 張麗 , 蔣明 ,  鄒立群

四川大學華西醫院腫瘤中心腫瘤（成都，610041）;

關鍵詞：

乳腺癌雌激素受體孕激素受體人表皮生長因子受體2 分子亞型

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目的　研究乳腺癌患者雌激素受體（ER）、孕激素受體（PR）、人表皮生長因子受體2（HER-2）表達情況及免疫組織化學分子亞型分布。方法　對2003年1月－2008年9月四川大學華西醫院病理科3 365例乳腺癌病理報告存檔資料進行激素受體（ER/PR）、HER-2表達情況及免疫組織化學分子亞型分布進行分析。結果　3 365例確診的乳腺癌患者中，ER陽性1 824例（54.2%），PR陽性1 841例（54.7%），HER-2過表達284例（8.4%）。相關分析顯示ER與PR表達呈正相關（P＜0.001），HER-2與ER、PR表達均呈負相關（P＜0.001）。免疫組織化學分子亞型結果顯示luminal A型最常見，為1 993例（59.2%）；basal-like型為623例（18.5%）；HER-2過表達型為169例（5.0%）；luminal B型最少，為115例（3.4%）；未分類的為465例（13.8%）。結論　乳腺癌患者激素受體及HER-2表達有特殊性，激素受體陽性率＞50%，HER-2陽性率在不同研究中顯示出不同的結果，尚需進一步研究；ER、PR與HER-2具有良好的相關性；免疫組織化學分子亞型中luminal A型最常見。

引用本文： 鄧窈窕,張麗,蔣明,鄒立群. 乳腺癌患者激素受體、人表皮生長因子受體2表達與免疫組織化學分子亞型分析. 華西醫學, 2012, 27(4): 491-494. doi: 復制

1.	Wong FY, Chin FK, Lee KA, et al. Hormone receptors and HER-2 status as surrogates for breast cancer molecular subtypes prognosticate for disease control in node negative Asian patients treated with breast conservation therapy[J]. Ann Acad Med Singapore, 2011, 40(2): 90-97.
2.	Voduc KD, Cheang MC, Tyldesley S, et al. Breast cancer subtypes and the risk of local and regional relapse[J]. J Clin Oncol, 2010, 28(10): 1684-1691.
3.	Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study[J]. JAMA, 2006, 295(21): 2492-2502.
4.	Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes-dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J]. Ann Oncol, 2011, 22(8): 1736-1747.
5.	Chu KC, Anderson WF, Fritz A, et al. Frequency distributions of breast cancer characteristics classified by estrogen receptor and progesterone receptor status for eight racial/ethnic groups[J]. Cancer, 2001, 92(1): 37-45.
6.	Chu KC, Lamar CA, Freeman HP. Racial disparities in breast carcinoma survival rates: seperating factors that affect diagnosis from factors that affect treatment[J]. Cancer, 2003, 97(11): 2853-2860.
7.	Kurebayashi J, Moriya T, Ishida T, et al. The prevalence of intrinsic subtypes and prognosis in breast cancer patients of different races[J]. Breast, 2007, 16(Suppl 2): 72-77.
8.	Lund MJ, Butler EN, Bumpers HL, et al. High prevalence of triple-negative tumors in an urban cancer center[J]. Cancer, 2008, 113(3): 608-615.
9.	Liu ZB, Liu GY, Yang WT, et al. Triple-negative breast cancer types exhibit a distinct poor clinical characteristic in lymph node-negative Chinese patients[J]. Oncol Rep, 2008, 20(4): 987-994.
10.	Chow LW, Ho P. Hormonal receptor determination of 1,052 Chinese breast cancers[J]. J Surg Oncol, 2000, 75(3): 172-175.
11.	Stierer M, Rosen H, Weber R, et al. Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer. Correlation of histopathology and prognostic factors[J]. Ann Surg, 1993, 218(1): 13-21.
12.	Mckenzie F, Jeffreys M, ’t Mannetje A, et al. Prognostic factors in women with breast cancer: inequalities by ethnicity and socioeconomic position in New Zealand[J]. Cancer Causes Control, 2008, 19(4): 403-411.
13.	Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence[J]. Clin Cancer Res, 2007, 13(15 pt 1): 4429-4434.
14.	Lertsanguansinchai P, Chottetanaprasith T, Chatamra K, et al. Estrogen and progesterone receptors status in Thai female breast cancer patients: an analysis of 399 cases at King Chulalongkorn Memorial Hospital[J]. J Med Assoc Thai, 2002, 85(Suppl 1): S193-S202.
15.	al-Alwan NA, al-Kubaisy W, al-Rawaq K. Assessment of response to tamoxifen among Iraqi patients with advanced breast cancer[J]. East Mediterr Health J, 2000, 6(2-3): 475-482.
16.	Abadjian G, Antoun R. Breast carcinoma: evaluation of hormone receptors and pS2, erb-B2, P-glycoprotein and Ki-67 markers[J]. J Med Liban, 1996, 44(1): 10-15.
17.	Amr SS, Sa’di AR, Ilahi F, et al. The spectrum of breast diseases in Saudi Arab females: a 26 year pathological survey at Dhahran Health Center[J]. Ann Saudi Med, 1995, 15(2): 125-132.
18.	Ikpatt OF, Ndoma-Egba R. Oestrogen and progesterone receptors in Nigerian breast cancer: relationship to tumour histopathology and survival of patients[J]. Cent Afr J Med, 2003, 49(11-12): 122-126.
19.	Bird PA, Hill AG, Houssami N. Poor hormone receptor expression in East African breast cancer: evidence of a biologically different disease?[J]. Ann Surg Oncol, 2008, 15(7): 1983-1988.
20.	Nyagol J, Nyong’o A, Byakika B, et al. Routine assessment of hormonal receptor and her-2/neu status underscores the need for more therapeutic targets in Kenyan women with breast cancer[J]. Anal Quant Cytol Histol, 2006, 28(2): 97-103.
21.	Shak S. Overview of the trastuzumab(Herceptin)anti-HER2 monoclonal antibody clinical program in HER2-overexpressing metastatic breast cancer. Herceptin Multinational Investigator Study Group[J]. Semin Oncol, 1999, 26(4 Suppl 12): 71-77.
22.	el-A Helal T, Khalifa A, Kamel AS. Immunohistochemical expression of p53 and c-erbB2 proteins in breast cancer in Egypt[J]. Anticancer Res, 2000, 20(3B): 2145-2150.
23.	Kim MJ, Ro JY, Ahn SH, et al. Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes[J]. Hum Pathol, 2006, 37(9): 1217-1226.
24.	Huang CY, Wang MA. HER’s-2/neu overexpression in Chinese breast cancers:correlation with other prognostic factors[J]. J Formos Med Assoc, 1995, 94(11): 660-665.
25.	夏紅強, 何建蓉. K-i 67、EGFR、HER-2和p53在乳腺癌中的表達及其相關性[J]. 臨床腫瘤醫學雜志, 2011, 11(2): 139-143.
26.	Hussein MR, Abd-Elwahed SR, Abdulwahed AR. Alterations of estrogen receptors, progesterone receptors and c-erbB2 oncogene protein expression in ductal carcinomas of the breast[J]. Cell Biol Int, 2008, 32(6): 698-707.
27.	Ihemelandu CU, Naab TJ, Mezghebe HM, et al. Basal cell-like (triple-negative) breast cancer, a predictor of distant metastasis in African American women[J]. Am J Surg, 2008, 195(2): 153-158.
28.	Rakha E, El-Sayed M, Green A, et al. Prognostic markers in triple-negative breast cancer[J]. Cancer, 2007, 109(1): 25-32.
29.	Tamimi RM, Baer HJ, Marotti J, et al. Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer[J]. Breast Cancer Res, 2008, 10(4): R67.
30.	Bogina G, Bortesi L, Marconi M, et al. Comparison of hormonal receptor and HER-2 status between breast primary tumours and relapsing tumours: clinical implications of progesterone receptor loss[J]. Virchows Arch, 2011, 459(1): 1-10.
31.	Nishimura R, Osako T, Okumura Y, et al. Changes in the ER, PgR, HER2, p53 and Ki-67 biological markers between primary and recurrent breast cancer: discordance rates and prognosis[J]. World J Surg Oncol, 2011, 9: 131.

1. 　Wong FY, Chin FK, Lee KA, et al. Hormone receptors and HER-2 status as surrogates for breast cancer molecular subtypes prognosticate for disease control in node negative Asian patients treated with breast conservation therapy[J]. Ann Acad Med Singapore, 2011, 40(2): 90-97.
2. 　Voduc KD, Cheang MC, Tyldesley S, et al. Breast cancer subtypes and the risk of local and regional relapse[J]. J Clin Oncol, 2010, 28(10): 1684-1691.
3. 　Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study[J]. JAMA, 2006, 295(21): 2492-2502.
4. 　Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes-dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J]. Ann Oncol, 2011, 22(8): 1736-1747.
5. 　Chu KC, Anderson WF, Fritz A, et al. Frequency distributions of breast cancer characteristics classified by estrogen receptor and progesterone receptor status for eight racial/ethnic groups[J]. Cancer, 2001, 92(1): 37-45.
6. 　Chu KC, Lamar CA, Freeman HP. Racial disparities in breast carcinoma survival rates: seperating factors that affect diagnosis from factors that affect treatment[J]. Cancer, 2003, 97(11): 2853-2860.
7. 　Kurebayashi J, Moriya T, Ishida T, et al. The prevalence of intrinsic subtypes and prognosis in breast cancer patients of different races[J]. Breast, 2007, 16(Suppl 2): 72-77.
8. 　Lund MJ, Butler EN, Bumpers HL, et al. High prevalence of triple-negative tumors in an urban cancer center[J]. Cancer, 2008, 113(3): 608-615.
9. 　Liu ZB, Liu GY, Yang WT, et al. Triple-negative breast cancer types exhibit a distinct poor clinical characteristic in lymph node-negative Chinese patients[J]. Oncol Rep, 2008, 20(4): 987-994.
10. 　Chow LW, Ho P. Hormonal receptor determination of 1,052 Chinese breast cancers[J]. J Surg Oncol, 2000, 75(3): 172-175.
11. 　Stierer M, Rosen H, Weber R, et al. Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer. Correlation of histopathology and prognostic factors[J]. Ann Surg, 1993, 218(1): 13-21.
12. 　Mckenzie F, Jeffreys M, ’t Mannetje A, et al. Prognostic factors in women with breast cancer: inequalities by ethnicity and socioeconomic position in New Zealand[J]. Cancer Causes Control, 2008, 19(4): 403-411.
13. 　Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence[J]. Clin Cancer Res, 2007, 13(15 pt 1): 4429-4434.
14. 　Lertsanguansinchai P, Chottetanaprasith T, Chatamra K, et al. Estrogen and progesterone receptors status in Thai female breast cancer patients: an analysis of 399 cases at King Chulalongkorn Memorial Hospital[J]. J Med Assoc Thai, 2002, 85(Suppl 1): S193-S202.
15. 　al-Alwan NA, al-Kubaisy W, al-Rawaq K. Assessment of response to tamoxifen among Iraqi patients with advanced breast cancer[J]. East Mediterr Health J, 2000, 6(2-3): 475-482.
16. 　Abadjian G, Antoun R. Breast carcinoma: evaluation of hormone receptors and pS2, erb-B2, P-glycoprotein and Ki-67 markers[J]. J Med Liban, 1996, 44(1): 10-15.
17. 　Amr SS, Sa’di AR, Ilahi F, et al. The spectrum of breast diseases in Saudi Arab females: a 26 year pathological survey at Dhahran Health Center[J]. Ann Saudi Med, 1995, 15(2): 125-132.
18. 　Ikpatt OF, Ndoma-Egba R. Oestrogen and progesterone receptors in Nigerian breast cancer: relationship to tumour histopathology and survival of patients[J]. Cent Afr J Med, 2003, 49(11-12): 122-126.
19. 　Bird PA, Hill AG, Houssami N. Poor hormone receptor expression in East African breast cancer: evidence of a biologically different disease?[J]. Ann Surg Oncol, 2008, 15(7): 1983-1988.
20. 　Nyagol J, Nyong’o A, Byakika B, et al. Routine assessment of hormonal receptor and her-2/neu status underscores the need for more therapeutic targets in Kenyan women with breast cancer[J]. Anal Quant Cytol Histol, 2006, 28(2): 97-103.
21. 　Shak S. Overview of the trastuzumab(Herceptin)anti-HER2 monoclonal antibody clinical program in HER2-overexpressing metastatic breast cancer. Herceptin Multinational Investigator Study Group[J]. Semin Oncol, 1999, 26(4 Suppl 12): 71-77.
22. 　el-A Helal T, Khalifa A, Kamel AS. Immunohistochemical expression of p53 and c-erbB2 proteins in breast cancer in Egypt[J]. Anticancer Res, 2000, 20(3B): 2145-2150.
23. 　Kim MJ, Ro JY, Ahn SH, et al. Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes[J]. Hum Pathol, 2006, 37(9): 1217-1226.
24. 　Huang CY, Wang MA. HER’s-2/neu overexpression in Chinese breast cancers:correlation with other prognostic factors[J]. J Formos Med Assoc, 1995, 94(11): 660-665.
25. 　夏紅強, 何建蓉. K-i 67、EGFR、HER-2和p53在乳腺癌中的表達及其相關性[J]. 臨床腫瘤醫學雜志, 2011, 11(2): 139-143.
26. 　Hussein MR, Abd-Elwahed SR, Abdulwahed AR. Alterations of estrogen receptors, progesterone receptors and c-erbB2 oncogene protein expression in ductal carcinomas of the breast[J]. Cell Biol Int, 2008, 32(6): 698-707.
27. 　Ihemelandu CU, Naab TJ, Mezghebe HM, et al. Basal cell-like (triple-negative) breast cancer, a predictor of distant metastasis in African American women[J]. Am J Surg, 2008, 195(2): 153-158.
28. 　Rakha E, El-Sayed M, Green A, et al. Prognostic markers in triple-negative breast cancer[J]. Cancer, 2007, 109(1): 25-32.
29. 　Tamimi RM, Baer HJ, Marotti J, et al. Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer[J]. Breast Cancer Res, 2008, 10(4): R67.
30. 　Bogina G, Bortesi L, Marconi M, et al. Comparison of hormonal receptor and HER-2 status between breast primary tumours and relapsing tumours: clinical implications of progesterone receptor loss[J]. Virchows Arch, 2011, 459(1): 1-10.
31. 　Nishimura R, Osako T, Okumura Y, et al. Changes in the ER, PgR, HER2, p53 and Ki-67 biological markers between primary and recurrent breast cancer: discordance rates and prognosis[J]. World J Surg Oncol, 2011, 9: 131.

《華西醫學》

乳腺癌患者激素受體、人表皮生長因子受體2表達與免疫組織化學分子亞型分析

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《華西醫學》

乳腺癌患者激素受體、人表皮生長因子受體2表達與免疫組織化學分子亞型分析

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