S.Shanthala原发部位和转移部位之间受体的免疫表型不一致显着影响治疗结果。当前的国际指南建议对可接近的转移性病变进行重新活检以重新评估组织生物标志物。虽然关于生物标志物变化的现有文献是相互矛盾和异质的,缺乏对印度乳腺癌患者队列的类似研究.在这种情况下,我们的目的是评估原发和复发部位活检之间生物标志物变化的频率,以及它们与各种临床病理特征的关联,包括转移性乳腺癌(MBC)患者的转移类型和治疗。这是在单个中心进行的综合研究。对MBC患者成对的原发和复发样本的免疫组织化学(IHC)表达进行了雌激素受体(ER)表达的回顾,孕激素受体(PR),人表皮生长因子2(HER2),Ki-67一致性,损失,根据ER的Allred评分评估受体的增益,PR,和HER2。Ki-67基于14%的临界值进行评估。Further,受体变化与年龄的关系进行了研究,更年期状态,形态学,grade,舞台,转移部位,活检之间的间隔,和治疗。在进步中,活检来自41.18%的局部复发和58.82%的转移部位.尽管ER和PR分别为47%和68.6%,真正的受体转化在9.8%观察到,21.56%,ER为5.88%,PR,分别为HER2。年龄与ER不一致之间存在显着相关性(p=0.029)。PR的损失与Ki-67的增加显着相关。在所有转移部位中,肺与PR和Ki-67一致性显著相关(分别为p=0.008和p=0.0425).受体的不一致与活检部位(局部复发或转移部位)或活检之间的时间间隔无关。先前的化疗,或者激素疗法.总之,该疾病的转移性进展伴随着ER的年龄依赖性不一致。与ER相关的PR的无与伦比的变化表明,不依赖ER的途径可能会影响MBC中PR的表达。此外,PR丢失与Ki-67增加的并发性表明疾病进展具有侵袭性表型.因此,对样本进行受体表达的后续检测有助于确定预后和指导治疗决策.
S. Shanthala Immunophenotypic
discordance of receptors between primary and metastatic sites significantly impacts treatment outcomes. Current international guidelines recommend rebiopsy of accessible metastatic lesions to reassess tissue biomarkers. While existing literature on biomarker changes is conflicting and heterogeneous, similar studies on the Indian cohort of breast cancer patients are lacking. In this context, we aimed to evaluate the frequencies of biomarker changes between biopsies from primary and recurrent sites, and their association with various clinicopathological characteristics, including the type of metastasis and treatment in metastatic breast cancer (MBC) patients. This is an ambispective study performed at a single center. Immunohistochemical (IHC) expression of paired primary and recurrence samples of MBC patients was reviewed for the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and Ki-67. Concordance, loss, and gain of receptors were assessed based on the Allred scores for ER, PR, and HER2. Ki-67 was assessed based on a 14% cutoff. Further, receptor changes were studied in relation to age, menopausal status, morphology, grade, stage, metastatic sites, interval between biopsies, and treatment. At progression, biopsies were obtained from 41.18% of locoregional recurrence and 58.82% of metastatic sites. Despite high
discordance of 47% for ER and 68.6% for PR, true receptor conversion was observed in 9.8%, 21.56%, and 5.88% for ER, PR, and HER2, respectively. There was a significant correlation between age and ER
discordance ( p = 0.029). Loss in PR significantly correlated with a gain in Ki-67. Of all the metastatic sites, the lung was significantly associated with PR and Ki-67 concordance ( p = 0.008 and p = 0.0425, respectively).
Discordance of receptors was neither related to the sites of biopsy (local recurrence or metastatic site) nor to the time interval between biopsies, prior chemotherapy, or hormone therapy. In conclusion, metastatic progression of the disease is accompanied by age-dependent
discordance of ER. Unparalleled changes in PR in relation to ER suggest that ER-independent pathways may influence PR expression in MBC. Furthermore, the concurrence of PR loss with Ki-67 gain indicates an aggressive phenotype with disease progression. Hence, follow-up testing of samples for receptor expression is beneficial in determining prognosis and guiding therapeutic decisions.