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低雌激素受体阳性乳腺癌的临床和生物学意义

Shorouk Makhlouf¹, Maryam Althobiti², Michael Toss³

¹Nottingham Breast Cancer Research Centre, Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

|July 20, 2023

概括

雌激素受体低阳性乳腺癌 (BC) 通常是ER阴性. 建议在BC病例中重复检测ER状态,其表达率为1-9%,以改善治疗决策.

科学领域:

在瘤学瘤学.
病理学病理学病理学
分子生物学分子生物学

背景情况:

雌激素受体 (ER) 状态对于乳腺癌 (BC) 的分类和治疗至关重要.
ER-低阳性BC (1-9%表达) 代表了一个独特的子组,其生物和临床特征不明确.

研究的目的:

为了研究ER-低阳性BC的异质性.
确定ER-低阳性BC是否包括ER-阳性和ER-阴性瘤的混合体.
为了比较ER-低阳性BC与ER-阳性和ER-阴性BC的临床病理学和结果特征.

主要方法:

对一个大规模的BC队列 (n=8171) 的分析,按ER表达水平分类.
使用IHC,RNAscope和RT-qPCR对ER低阳性病例的详细评估.
从癌症基因组图谱 (TCGA) 中评估ER-低阳性病例中的PAM50亚型和ESR1mRNA表达.

主要成果:

低ER阳性瘤 (<2%的病例) 与ER阴性BC具有临床病理相似性.
45%的低ER阳性瘤在重复测试和分子分析后被证实为ER阴性.
低阳性ER瘤经常具有低ESR1mRNA表达的非光线,针芯活检显示出错误阳性ER染色.

结论:

常规诊断的ER-低阳性BC包括相当一部分ER-阴性病例.
建议修订≥10%的ER表达的切割值来定义ER阳性.
在表达率为1-9%的病例中,重复测试ER状态对于准确的诊断和治疗规划至关重要.

关键词:

评估评估的评估评估的评估.乳腺癌乳腺癌乳腺癌雌激素受体的受体是雌激素受体.低表达能力,表达能力较低.陷陷陷是一个陷.

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