免疫和基因表达在雌激素受体低和负早期乳腺癌中的概况
Davide Massa1,2, Claudio Vernieri3,4, Lorenzo Nicolè5
1Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
Journal of the National Cancer Institute
|July 31, 2024
概括
低雌激素受体 (ER-low) 和ER阴性乳腺癌具有相似的瘤免疫微环境和基因表达. 这表明可比的结果和治疗反应,包括免疫疗法,合理的重新分类.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 基因组学就是基因组学.
背景情况:
- 在乳腺癌 (BC) 中使用<1%的免疫组织化学 (IHC) 切割值来定义雌激素受体 (ER) 消极性的定义是有争议的.
- 早期的HER2-阴性BC具有低ER表达率 (1% - 9%),需要进一步调查其瘤免疫微环境和基因表达特征.
研究的目的:
- 为了比较低ERBC的瘤免疫微环境和基因表达特征,与ER负BC和ER中间BC进行比较.
- 探索这些相似之处和差异的临床影响,特别是关于治疗反应和存活率.
主要方法:
- 对921名早期,HER2阴性BC患者的分析,分类为ER阴性 (<1%),ER低 (1% - 9%),或ER中间 (10% - 50%).
- 通过IHC和数字病理学评估瘤透淋巴细胞 (TIL),CD8+,FOXP3+细胞和PD-L1状态.
- 在116个瘤样本中分析了776个BC相关基因.
主要成果:
- 低ER和ER阴性瘤的TIL中位数相似,明显高于ER中间瘤.
- 在低ER和ER负组中,CD8/FOXP3比率和PD-L1阳性是可比的,基底类亚型和免疫基因表达的丰富性相似.
- 高TILs (≥30%) 与改善的无复发存活率相关,无论是低ER和ER负BC.
结论:
- 低ER和负ER的乳腺癌代表了类似的生物和分子实体.
- 这些发现支持可比的临床结果和治疗反应,包括免疫疗法,低ER和ER阴性瘤.
- 建议重新评估ER-阳性BC分类和管理,更紧密地对准ER-低和ER-负瘤.
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