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Luteinizing hormone receptor status and clinical, pathologic, and prognostic features in patients with breast
Geri Meduri1, Nathalie Charnaux, Frederique Spyratos
1Unité de Recherche INSERM U 135 Hormones, Gènes et Reproduction, Hôpital Bicêtre, Le Kremlin Bicetre Cedex, France.
Background:
It has been established that pregnancy protects against breast carcinoma, and animal models have shown that human chorionic gonadotropin (hCG) mimics this effect by inhibiting the initiation and progression of experimental breast carcinoma. Luteinizing hormone (LH)/hCG receptors (LHR) have been characterized in several human breast carcinoma cell lines and in a limited number of breast carcinoma biopsy specimens. These observations led to the suggestion that hCG may be used as a means of prevention and possibly treatment in patients with breast carcinoma.
Methods:
The authors used immunocytochemistry to analyze tumors from 160 patients who were followed for a median of 2539 days. Using a cut-off value of 18% immunolabeled cells in each tumor, 72% of tumors were identified as LHR positive. The LHR-positive tumors were found more frequently in premenopausal women, who had tumors with greater cell differentiation and positive estrogen receptor alpha status. Infiltrating lobular carcinomas were positive for LHR more frequently compared with infiltrating ductal carcinomas. There was no correlation between LHR status and lymph node invasion, tumor size, or progesterone receptor status.
Results:
Patients with LHR-positive tumors had a longer metastasis free survival, although the statistical significance was slight (P = 0.07), most likely due to the limited number of events in the patients studied. Conversely, there was no difference between patients with LHR-positive or LHR-negative tumors in the local recurrence free interval.
Conclusions:
LHR status seems to be related in part to the degree of differentiation in breast tumors, confirming experimental evidence of the effect of hCG on mammary tissue. The presence of LHR is a tumor characteristic that largely is independent of other clinical and pathologic tumor features. It may be of interest in the future to correlate the presence of LHR with a possible therapeutic response in individual patients to hCG.