■探讨166例浸润性乳腺癌患者转移过程中受体异质性与临床病理特征的关系。
■我们对166例经活检确诊为转移性乳腺癌的患者进行了回顾性分析,他们于2018年1月至2022年12月入住我们医院。统计分析用于评估原发性和转移性病变中受体的异质性。包括雌激素受体(ER),孕激素受体(PR),人表皮生长因子受体2(HER2),Ki67,以及它们与临床病理特征如肿瘤大小的关系,淋巴结转移,治疗方案,和无病生存。
■ER的不一致表达率,PR,原发灶和转移灶的HER2、Ki-67和管腔分类分别为21.7%,41.6%,8.9%,34.4%和36.8%,分别。原发灶和转移灶受体状态一致和不一致的患者的无病生存率存在显著差异,具有统计学意义。原发性HER2(-)至转移性HER2(+)的中位DFS为84个月,相对较高。Cox多元回归分析显示,ER、PR,HER2和Ki67不受内分泌治疗和化疗的影响。然而,在靶向治疗中观察到HER2表达的统计学显著差异.肿瘤大小与ER和Ki67受体状态相关(P=0.019、0.016)。肿瘤大小与PR无关,和HER2(P=0.679,0.440)。淋巴结转移与ER改变无关,PR,HER2和Ki67。ER的不一致率,PR,HER2和Ki-67在局部复发患者中分别为22%,23.7%,5.1%,和28.8%,而远处转移患者的比例为21.5%,36.4%,10.3%,和31.8%。
■ER的表达水平,PR,HER2和Ki-67在原发性和转移性乳腺癌中表现出异质性,这与患者的预后和治疗结果密切相关。
UNASSIGNED: To explore the relationship between receptor heterogeneity and clinicopathological characteristics in 166 patients with invasive breast cancer during metastasis.
UNASSIGNED: We conducted a retrospective analysis of 166 patients diagnosed with metastatic breast cancer through biopsy, who were admitted to our hospital from January 2018 to December 2022. Statistical analysis was employed to assess the heterogeneity of receptors in both primary and metastatic lesions, including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), Ki67, as well as their association with clinicopathological features such as tumor size, lymph node metastasis, treatment regimen, and disease-free survival.
UNASSIGNED: The discordant expression rates of ER, PR, HER2, Ki-67 and Luminal classification between primary and metastatic lesions were 21.7%, 41.6%, 8.9%, 34.4% and 36.8%, respectively. There is a significant difference in disease-free survival between patients with consistent and inconsistent receptor status of primary and metastatic lesions, which is statistically significant. The median DFS for primary HER2(-) to metastatic HER2(+) was 84 months, which was relatively high. The Cox multivariate regression analysis revealed that the expression differences of ER, PR, HER2, and Ki67 were not influenced by endocrine therapy and chemotherapy. However, a statistically significant difference in HER2 expression was observed with targeted therapy. Tumor size was correlated with ER and Ki67 receptor status (P = 0.019, 0.016). Tumor size was not correlated with PR, and HER2 (P = 0.679, 0.440). Lymph node metastasis was not associated with changes in ER, PR, HER2, and Ki67. The discordant rates of ER, PR, HER2, and Ki-67 in patients with local recurrence were 22%, 23.7%, 5.1%, and 28.8% respectively, whereas those in patients with distant metastasis were 21.5%, 36.4%, 10.3%, and 31.8% respectively.
UNASSIGNED: The expression levels of ER, PR, HER2, and Ki-67 in primary and metastatic breast cancer exhibit heterogeneity, which is closely associated with the prognosis and treatment outcomes of patients.