雌激素受体阴性/孕激素受体阳性乳腺癌在新辅助化疗后具有独特的特征和病理完整反应率
He Dou1, Fucheng Li1, Youyu Wang1
1Department of Breast Surgery, Harbin Medical University Cancer Hospital, No.150, Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China.
Diagnostic pathology
|January 4, 2024
概括
激素受体状态显著影响乳腺癌存活率和化疗反应. 乳腺癌ER-/PR+亚型表现出侵略性特征,并从化疗中获益,需要量身定制的治疗策略.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 遗传学 遗传学 是一个
背景情况:
- 激素受体 (HR) 状态,特别是雌激素受体 (ER) 和孕激素受体 (PR),对于乳腺癌 (BC) 预后和治疗敏感性至关重要.
- 乳腺癌ER-/PR+亚型在治疗策略的确定中提出了独特的挑战,因为其有争议的临床影响.
研究的目的:
- 系统地分析ER-/PR+乳腺癌表型的临床病理学特征.
- 评估ER-/PR+乳腺癌表型患者的化疗反应和生存结果.
主要方法:
- 分析了两个大型队列:来自SEER数据库的72,666名女性患者的生存结果和哈尔医科大学癌症医院的879名患者的病理完整反应 (pCR) 率.
- 统计分析包括千平方测试,菲斯特的精确测试,逻辑回归和卡普兰-梅尔生存分析,以评估HR状态,临床病理学数据,生存率和pCR之间的关系.
主要成果:
- 在两个队列中,ER-/PR+表型分别在0.9%和1.3%的患者中观察到,并且在更年轻的绝经前妇女中更常见,具有更高的组织学等级.
- 在不同HR状态 (P < 0.001) 中,在总生存率 (OS) 和乳腺癌特异性生存率 (BCSS) 中发现了显著差异,ER+/PR+显示最佳生存率和ER-/PR+预后类似于ER-/PR-.
- HR状态独立预测了新辅助化学疗法 (NAC) 后的PCR率,ER+/PR-和ER-/PR-表型对化学疗法比ER+/PR+更敏感.
结论:
- 激素受体状态是乳腺癌存活率和pCR率的主要决定因素.
- 乳腺癌 ER-/PR+ 现型表现出侵略性的生物因素,并显示化学疗法具有显著的益处,突出了需要个性化治疗方法的需要.
- 进一步关注ER-/PR+组可以改善BC治疗,并提供新的临床点.
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