Identification of Luminal Subtypes of Breast Carcinoma Using Surrogate Immunohistochemical Markers and Ascertaining Their Prognostic Relevance
Autor: | N. Nair, Anuj Verma, Asawari Patil, Akash Sali, Rohini Hawaldar, Sangeeta Desai, Trupti Pai, Sudeep Gupta, Tanuja Shet, Nishtha Sharma, V. Parmar, Amruta Beke |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Cancer Research Pathology medicine.medical_specialty Receptor ErbB-2 Estrogen receptor Labeling index Breast Neoplasms 03 medical and health sciences 0302 clinical medicine Breast cancer Biomarkers Tumor medicine Humans Human Epidermal Growth Factor Receptor 2 Mastectomy Retrospective Studies business.industry Middle Aged Prognosis medicine.disease Immunohistochemistry Survival Rate 030104 developmental biology Receptors Estrogen Oncology Hormone receptor 030220 oncology & carcinogenesis Female Receptors Progesterone Breast carcinoma business Statistical correlation Follow-Up Studies |
Zdroj: | Clinical Breast Cancer. 20:382-389 |
ISSN: | 1526-8209 |
Popis: | Background Therapeutic decisions in breast carcinoma are being made on the basis of tumor cell proliferation using exorbitant genomic tests. The 2013 St Gallen meeting advocated surrogate definitions for classifying tumors into luminal subtypes on the basis of immunohistochemical (IHC) markers. We studied the classification of estrogen receptor (ER)-positive tumors using these definitions as well as different methods for Ki-67 labeling index (LI) estimation. Patients and Methods A total of 541 ER+ invasive breast carcinoma cases from January 2012 to December 2012 were evaluated for Ki-67 LI by the average and hot spot methods. The IHC results of ER, PR, and human epidermal growth factor receptor 2 (HER2) were noted. HER2 IHC equivocal (2+) samples were subjected to HER2 fluorescence in-situ hybridization testing. Luminal subgroups created on the basis of the 2013 St Gallen meeting guidelines were correlated with clinicopathologic variables and disease-free survival. Results The distribution of luminal subtypes was as follows: luminal A–like, 13.3%; luminal B–like (HER2−), 57.9%; and luminal B–like (HER2+), 28.8%. Approximately 6% of cases were recategorized into different subgroups when the average method was used instead of the hot spot method for Ki-67 LI assessment. Younger patients (≤ 50 years), grade 3 tumors, positive axillary nodes, recurrence, and distant metastasis had a positive statistical correlation with luminal B–like (HER2−) subtype. Patients with luminal B–like (HER2−) tumors had a shorter disease-free survival compared to patients with luminal A–like tumors. Conclusion Ki-67 LI, irrespective of the method of assessment, along with PR, can be efficiently used to divide ER+ tumors into prognostic subgroups in Indian patients. |
Databáze: | OpenAIRE |
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