Advancing breast cancer subtyping: optimizing immunohistochemical staining classification with insights from real-world Taiwanese data.

Autor:	Chang YT; School of Public Health, National Defense Medical Center Taipei 114, Taiwan., Hong ZJ; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Yu JC; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Lin WZ; AIoT Center, Tri-Service General Hospital Taipei 114, Taiwan., Huang TY; School of Public Health, National Defense Medical Center Taipei 114, Taiwan., Tsai HH; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Feng AC; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Hsu KF; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Huang CC; Department of Surgery, Taipei Veterans General Hospital No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei 11217, Taiwan.; Comprehensive Breast Health Center, Taipei Veterans General Hospital No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei 11217, Taiwan.; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University No. 17, Xuzhou Rd., Taipei 100, Taiwan., Chu CM; School of Public Health, National Defense Medical Center Taipei 114, Taiwan., Liang CM; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan., Liao GS; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center Taipei 114202, Taiwan.
Jazyk:	angličtina
Zdroj:	American journal of cancer research [Am J Cancer Res] 2023 Nov 15; Vol. 13 (11), pp. 5719-5732. Date of Electronic Publication: 2023 Nov 15 (Print Publication: 2023).
Abstrakt:	Gene expression signatures provide valuable information to guide postoperative treatment in breast cancer (BC) patients. However, genetic tests are prohibitively expensive for the majority of BC patients. Immunohistochemical staining (IHC) subtype classification system has been widely used for treatment guideline and is affordable to most BC patients. We aimed to revise immunohistochemical staining (IHC) subtyping to better match gene expression-based Prediction Analysis of Microarray 50 (PAM50) subtyping. Real world data of 372 BC patients were recruited in the Tri-Service General Hospital between Jan 2019 and Dec 2021. Clinical pathological information, blood, twelve pathological tissue slide samples, and fresh surgical tumor specimens were collected to examine IHC and PAM50. Current IHC subtyping (cIHC) tends to misclassify PAM50-based luminal A (lum A) to luminal B (lum B) by 35.81%, PAM50-lum B to PAM50-lum A by 9.09%, PAM50-Her2-enriched to lum B by 61.11%, PAM50-based Her2-enriched to lum B by 61.11%, and PAM50-based basal-like to lum B by 33.33%. We used random forest to identify estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her2), and Ki-67 status as the best indicators for revised IHC subtyping (rIHC4) and revised the classification rules by stratified analysis and prediction efficacy. rIHC4 increased the concordance rate for PAM50 subtypes from 68.3% to 74.7%. Both sensitivity and precision increased in most rIHC4 subtypes. Sensitivity increased from 33.3% to 87.4% in the Her2-enriched subtype; precision increased more evidently in the basal-like and lum B subtypes, from 71.4% to 83.3% and 57% to 65.1%, respectively. Our rIHC4 subtyping improved consistency with the PAM50 subtype, which could improve clinical management of BC patients without increasing medical expense. Competing Interests: None. (AJCR Copyright © 2023.)
Databáze:	MEDLINE
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