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Dash S, Nayak M, Samantaray S, Rout N, Ranjit M. Expression Pattern of Estrogen Receptor Alpha and Progesterone Receptor in Gallbladder Carcinoma and Their Association with Clinicopathological Parameters and Overall Survival. J Gastrointest Cancer 2024; 55:1154-1164. [PMID: 38762689 DOI: 10.1007/s12029-024-01045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Gallbladder cancer (GBC) is a highly aggressive malignant tumor with a poor prognosis. Despite being first described two centuries ago, there are no targeted therapies available beyond conventional cytotoxic therapy. Epidemiological studies have shown that the incidence of gallbladder cancer is higher in females than males. This suggests that the gallbladder may be a female sex hormone-responsive organ, and these hormones might be involved in the pathogenesis of gallbladder cancer. Therefore, we aimed to analyze the expression of ERα and PR in GBC and correlate their expression with clinicopathological variables and overall survival. PATIENTS AND METHODS A total of 235 histopathologically diagnosed GBC cases were included in this hospital-based cross-sectional study. Clinicopathological data were collected, and the expression of ERα and PR was evaluated by immunohistochemistry. RESULTS The mean age of this study population was 55.47 ± 8.45 with range 28-87 years. Females were predominated over male with a male-to-female ratio of 1:3.5. Positive nuclear expression of the ERα and PR was found in 13 (5.5%) and eight (3.4%) cases, respectively. Apart from nuclear staining, cytoplasmic expression of ERα and PR was found in three (1.2%) and 31 (13.2%) cases, respectively. Higher percentage of positive nuclear expression of ER was found in < 50 years age (p value = 0.04), parity > 4 (p value = 0.02), advanced pT stage (T3) (p value = 0.01), lymphovascular invasion (p value = 0.02), and liver invasion (p value = 0.04) which were statistically significant. Higher percentage of PR expression was also observed in < 50 years age (p value = 0.01), and tumor associated with gallstone (p value = 0.04). There was no significant correlation between cytoplasmic expression of ER, PR, and clinicopathological variables. In multivariate analysis, there was no significant correlation between ER or PR positive expression and overall survival. CONCLUSION Although nuclear expression of ERα was significantly associated with progressive disease factors but the positive expression was found in very small percentage of GBC cases. So anti-hormone therapy might be an option in patient with ER α positive gallbladder carcinoma.
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Affiliation(s)
- Sashibhusan Dash
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India.
- Division of Molecular Epidemiology and Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India.
| | - Mamita Nayak
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India
| | - Sagarika Samantaray
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India
| | - Niranjan Rout
- Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, India
| | - Manoranjan Ranjit
- Division of Molecular Epidemiology and Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Wu Y, Quan Y, Zhou D, Li Y, Wen X, Liu J, Long W. Overexpression of cytoplasmic poly(A)-binding protein 1 as a biomarker for the prognosis and selection of postoperative regimen in breast cancer. Clin Transl Oncol 2024:10.1007/s12094-024-03663-6. [PMID: 39172332 DOI: 10.1007/s12094-024-03663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE The dysregulation of the cytoplasmic poly(A)-binding protein 1 (PABPC1) is involved in a variety of tumors but little is known about its role in human breast cancer. Therefore, the effect of PABPC1 in the prognosis and regimen selection in breast cancer patients was evaluated. METHODS A total of 791 cases of invasive breast cancer were included in this study, although only 416 were involved in subsequent analyses after the propensity score matching (PSM) test. PABPC1 expression was detected by immunohistochemistry. The relationship between PABPC1 expression and clinicopathological factors, postoperative regimens, and outcomes was determined. RESULTS In the total 791 cases, 583 cases were positive for PABPC1, but only 212 (26.8%) showed high PABPC1 expression (PABPC1-HE). The overall survival (OS) and disease-free survival (DFS) of PABPC1-HE patients after PSM were significantly worse than those in patients with PABPC1 low expression (PABPC1-LE), regardless of age, molecular type, tumor size, nodal status, or pStage. Postoperative chemotherapy (CT) increased the OS of PABPC1-HE patients but not that of PABPC1-LE patients. Among patients receiving endocrine therapy, those in the PABPC-LE group had an extended OS, while CT or chemoradiotherapy (CT/CRT) only significantly extended the OS time of PABPC-HE patients. CT/CRT did not significantly extend the survival of PABPC1-LE HER2-positive patients but extended the OS of PABPC1-HE HER2-positive patients. However, the OS of patients treated with CT/CRT + trastuzumab therapy was significantly longer than that of other patients under other therapies in the PABPC1-HE group, suggesting that PABPC1-HE might be sensitive to trastuzumab-based therapy. The multivariate analysis revealed that PABPC1-HE was an independent prognostic factor for both poor OS and DFS in breast cancer except luminal A type. CONCLUSIONS Our results revealed that PABPC1 might be considered as a biomarker to help in subtyping, as well as in the prognosis and regimen selection of breast cancer patients.
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Affiliation(s)
- Yunqiu Wu
- Department of Breast Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Yi Quan
- Department of Breast Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Dan Zhou
- Department of Breast Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Yixian Li
- Department of Breast Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Xue Wen
- Department of Pathology, The Affiliated Hospital, Southwest Medical University, Jiangyang District, Taiping Street No. 25, Luzhou, China
| | - Jun Liu
- Department of Pathology, The Affiliated Hospital, Southwest Medical University, Jiangyang District, Taiping Street No. 25, Luzhou, China
| | - Wenbo Long
- Department of Pathology, The Affiliated Hospital, Southwest Medical University, Jiangyang District, Taiping Street No. 25, Luzhou, China.
- Luzhou Key Laboratory of Precision Pathology Diagnosis for Serious Diseases, Luzhou, China.
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Wang T, Wang J, Zhao W, Pan Y. Clinical Outcomes and Intrinsic Subtypes of Breast Cancer Patients with Single Hormone Receptor-positive Receiving Neoadjuvant Chemotherapy. Clin Breast Cancer 2024; 24:e370-e378.e1. [PMID: 38503615 DOI: 10.1016/j.clbc.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/25/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Extensive studies have highlighted the significance of estrogen receptor (ER) and progesterone receptor (PR) in breast cancer (BRCA). However, our understanding of patients with single hormone receptor (HR)-positive (sHR+) BRCA remains limited. This lack of understanding poses challenges in predicting prognosis and selecting appropriate treatments. PATIENTS AND METHODS We collected data from a total of 825 human epidermal growth factor receptor 2 negative (HER2-) BRCA patients who underwent neoadjuvant chemotherapy (NAC) in two distinct cohorts. Four subgroups were created within each cohort based on their HR expression: ER+/PR+, ER+/PR-, ER-/PR+, and ER-/PR-. We conducted comparative analyses to assess clinicopathological characteristics, chemotherapy responsiveness, clinical outcomes, and intrinsic subtyping among these subgroups. RESULTS ER+/PR- constituted 11.1% and 14.9% of samples in two cohorts, respectively, whereas ER-/PR+ comprised 8.3% and 3.7%. Higher histologic grades were more common in the ER-/PR+ group as compared to the ER+/PR+ subgroup (P = .0075 in cohort 1; P = .026 in cohort 2). Additionally, after multivariable analysis, ER-/PR+ were more likely to achieve pathological complete response (pCR) (cohort 1: OR =6.67; 95%CI, 2.63-16.94; P < .001; cohort 2: OR =3.70; 95%CI, 1.08-11.84; P = .030;). Between ER+/PR- and ER+/PR+, the distant recurrence-free survival (DRFS) was comparable. The survival outcomes in the ER-/PR+ subgroup present a partial inconsistency between the 2 cohorts. Furthermore, the ER-/PR+ subgroup exhibited a higher incidence of the basal-like subtype, while the ER+/PR- subgroup had a higher proportion of luminal-like subtypes. CONCLUSION This study highlighted the distinct clinical and genetic characteristics of sHR+ BRCA, emphasizing the potential need for optimized treatment strategies.
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Affiliation(s)
- Tingting Wang
- Department of Medical Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui Province, China, 230032
| | - Jinnan Wang
- Department of Medical Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui Province, China, 230032
| | - Wei Zhao
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yueyin Pan
- Department of Medical Oncology, Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui Province, China, 230032.
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Gan L, Xie J, Li K, Xu Z, Wang X, Pei X, Xue B. Triple-Negative or Close-to-Triple-Negative Breast Cancer Presenting as a Thick-Walled Cystic Lesion. Am Surg 2024; 90:1756-1759. [PMID: 38298032 DOI: 10.1177/00031348241230089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Clinical and pathologic characteristics of the invasive ductal carcinoma (IDC) presenting as a thick-walled breast cyst are little known. Three female patients were included in this report. A palpable, nontender breast lump was found in all cases. While mammography showed a hyperdense mass, ultrasonography demonstrated a thick-walled cystic mass. Magnetic resonance imaging clearly showed the cystic breast lesions with ring-like or irregular rim enhancement. A grade III IDC was confirmed in all cases. All IDCs but one were estrogen receptor negative, progesterone receptor negative, and human epidermal growth factor receptor 2 negative, with merely weak progesterone receptor positivity (5%) in one case. All cases underwent surgical management first and postoperative chemotherapy. Breast malignancy presenting as a thick-walled cystic mass could be a highly aggressive IDC, even triple-negative breast cancer. It is imperative for breast cancer-related practitioners to identify the potentially malignant cystic lesions timely and adopt appropriate management.
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Affiliation(s)
- Li Gan
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Junyuan Xie
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Kaiqiang Li
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Zimeng Xu
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Xinxing Wang
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Xinhong Pei
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Bingjian Xue
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
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Shao HY, Hao BT, Gao FX. The Association between ER, PR, HER2, and ER-/PR+ Expression and Lung Cancer Subsequent in Breast Cancer Patients: A Retrospective Cohort Study Based on SEER Database. Breast J 2023; 2023:7028189. [PMID: 38021219 PMCID: PMC10657240 DOI: 10.1155/2023/7028189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Aims The available research on the association between estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), ER-/PR+ status, and the occurrence of lung cancer subsequent to breast cancer in patients (referred to as BC-LuC) had been limited. Consequently, there is a need to examine whether ER, PR, HER2, and ER-/PR+ have independent correlations with the risk and outcomes of BC-LuC, while appropriately adjusting for other potential covariates. Methods The present study employed a cohort design and utilized data from the Surveillance, Epidemiology, and End Results (SEER) program spanning from 2010 to 2015. The study population consisted of 683,336 individuals who were diagnosed with breast cancer (referred to as BC). Various covariates were assessed at baseline, including age, sex, race, marital status, CS tumor size, laterality, radiation, chemotherapy, months from diagnosis to treatment, breast subtype, AJCC 7th edition (2010-2015), and combined summary stage (2004+). The primary objective of this study was to investigate the association between ER, PR, HER2, ER-/PR+ status, and the risk of developing BC-LuC. Logistic regression analysis was employed to assess this association. Furthermore, multivariable Cox regression analyses were conducted to calculate adjusted hazard ratios (HRs) along with their respective 95% confidence intervals (CIs). Kaplan-Meier plots and log-rank tests were utilized to estimate the outcomes, specifically overall survival (OS), disease-specific survival (DSS), and metastasis. Results The average age of 198,972 selected participants was 59.8 ± 13.1 years, and about 99.3% of them were female. Result of fully adjusted binary logistic regression showed PR+ and HER2+ were positively associated with lower risk BC-LuC after adjusting confounders (ORs = 0.84, 95% CI: 0.73-0.96, p = 0.011 and ORs = 0.83, 95% CI: 0.72-0.96, p = 0.012, respectively). ER+ and ER-/PR+ were detected no significant relationship with BC-LuC (ORs = 1.03, 95% CI: 0.87-1.22, p = 0.718 and ORs = 1.02, 95% CI: 0.61-1.72, p = 0.936, respectively). In subgroups analyses, the results remain stable. Multivariable Cox regression showed that BC-LuC patients with ER and PR were significantly associated with OS and DSS. However, ER, PR, HER2, and ER-/PR+ were significantly associated with OS and DSS in breast cancer patients. The relationship between ER, PR, HER2, and ER-/PR+ and metastasis in breast cancer patients was different. Conclusion The results of this study indicated a potential correlation between PR- and HER2- status and a risk of developing BC-LuC. Furthermore, it appears that the prognosis of BC-LuC may be influenced by the presence of ER+ and PR+. Therefore, additional research is warranted to fully investigate and validate this association.
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Affiliation(s)
- Hong Yu Shao
- Department of CT/MR, Xingtai People's Hospital, Xingtai, Hebei, China
| | - Bao Tan Hao
- Department of Thoracic Surgery, Xingtai People's Hospital, Xingtai, Hebei, China
| | - Feng Xiao Gao
- Department of CT/MR, Xingtai People's Hospital, Xingtai, Hebei, China
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ER-/PR+ breast cancer is controlled more effectively with an inflammatory inhibitor than hormonal inhibitor. Breast Cancer 2023; 30:436-452. [PMID: 36859733 DOI: 10.1007/s12282-023-01437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/08/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND The anti-estrogen tamoxifen is a highly effective hormonal therapy for hormonal-positive (HR+) breast cancer patients; however, the estrogen receptor-negative, progesterone receptor-positive (ER-/PR+) subtype does not give the benefits of tamoxifen. Therefore ER-/PR+ breast cancer has a poor clinical outcome, and novel drug therapy for ER-/PR+ breast cancer could benefit these patients. METHODS 53,805 gene expressions were characterized into HR+ BC and triple-negative breast cancer (TNBC) and analyzed through Breast Cancer Gene Expression Miner in 4319 breast cancer patient samples. The clinical outcomes including overall survival, distant metastasis-free survival, and relapse-free survival were obtained from the PrognoScan database containing 1190 human breast cancer patient samples. To determine the function of ERα and inflammation-related genes such as USP1, CDC20, and CASP1, we used the CRISPR-Cas9 system or gene knockdown (KD) system. To check tumor cell proliferation and migration of ERα KO breast cancer cell line, we used tamoxifen and the inflammation inhibitor Ac-YVAD-CHO. For further confirmation, cancer growth was checked with the inflammation inhibitor in ERα KO breast cancer cell line using a three-dimensional (3D) organoid tissue culture system (ex vivo). RESULTS We found that gene expression in ER-/PR+ hormonal-positive breast cancer is positively related to ER-/PR- very similar to TNBC, not other HR+ breast cancer using a 4319 breast cancer patient database. Especially, inflammation-related genes, USP1, CDC20, and CASP1, which are highly expressed in TNBC, are also upregulated in ER-/PR+ HR+ breast cancer. Suppression of USP1, CDC20, and CASP1 inhibited tumor cell growth and metastasis in ERα KO (ER-/PR +) cell lines. Interestingly, loss of ERα in HR+ cell lines is not responsive to tamoxifen, but highly sensitive to the inflammation inhibitor, Ac-YVAD-CHO. In in vitro and ex vivo (3D organoid) models, inflammation inhibitor-specific blocks ER-/PR+ tumor proliferation and migration. CONCLUSIONS These findings suggest that an inflammation inhibitor might be a potential option for therapy for ER-/PR+ HR breast cancer patients.
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Westhoff CC, Ramaswamy A, Kalder M, Lebeau A, Sinn P, Denkert C. [Immunohistology in breast diagnostics : Strategies for efficient diagnostics]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:17-31. [PMID: 36576522 DOI: 10.1007/s00292-022-01174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 12/29/2022]
Abstract
Immunohistological examinations are useful for the histopathological diagnosis of breast carcinoma in various clinical situations. This review article aims to summarize the different immunohistological options. A distinction is made between diagnostic, prognostic, and predictive markers. Especially when a therapeutic decision results from the immunohistological expression pattern, a quantitative, quality-controlled, and validated diagnostic approach is essential.This is relevant, for example, for the classical markers ER, PR, and HER2, but also for Ki-67 and additional markers such as PD-L1. This article provides a practice-oriented summary of the most important immunohistochemical markers in routine breast cancer diagnosis and for the distinction of malignant findings from benign alterations or precursor lesions.
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Affiliation(s)
- Christina C Westhoff
- Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg (UKGM), Baldingerstr., 35043, Marburg, Deutschland.
| | - Annette Ramaswamy
- Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg (UKGM), Baldingerstr., 35043, Marburg, Deutschland
| | - Matthias Kalder
- Klinik für Frauenheilkunde und Geburtshilfe, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg (UKGM), Marburg, Deutschland
| | - Annette Lebeau
- Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland.,Gemeinschaftspraxis für Pathologie, Lübeck, Deutschland
| | - Peter Sinn
- Institut für Pathologie, Universität Heidelberg, Heidelberg, Deutschland
| | - Carsten Denkert
- Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg (UKGM), Baldingerstr., 35043, Marburg, Deutschland
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[Triple-negative breast cancer : Classification, current concepts, and therapy-related factors]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:32-38. [PMID: 36595080 DOI: 10.1007/s00292-022-01177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
Triple-negative breast cancer (TNBC) accounts for about 10% of all breast cancer cases and is defined by the lack of expression of estrogen and progesterone receptors and the lack of overexpression or amplification of HER2. It differs with regard to the younger age of the patients, an increased association with a mutation of BRCA1 and a mostly low differentiation from hormone receptor-positive breast cancer. The spectrum of triple-negative breast cancer shows considerable heterogeneity both at the morphological and at the molecular level. It includes most commonly TNBC of no special type, with and without basal phenotype, triple-negative metaplastic breast carcinomas, triple-negative breast carcinomas with apocrine differentiation and rare triple-negative tumor types. At the gene-expression level, TNBC most commonly is associated with a basal phenotype, with rarer molecular variants of TNBC involving the Claudin-low, molecular apocrine types, and other rarer subtypes. Therefore, a critical use of the term TNBC, considering the histopathological tumor differentiation, is recommended.
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Filippi A, Mocanu MM. Mining TCGA Database for Genes with Prognostic Value in Breast Cancer. Int J Mol Sci 2023; 24:1622. [PMID: 36675137 PMCID: PMC9862022 DOI: 10.3390/ijms24021622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
The aim of the study was to use transcriptomics data to identify genes associated with advanced/aggressive breast cancer and their effect on survival outcomes. We used the publicly available The Cancer Genome Atlas (TCGA) database to obtain RNA sequence data from patients with less than five years survival (Poor Prognosis, n = 101), patients with greater than five years survival (Good Prognosis, n = 200), as well as unpaired normal tissue data (normal, n = 105). The data analyses performed included differential expression between groups and selection of subsets of genes, gene ontology, cell enrichment analysis, and survival analyses. Gene ontology results showed significantly reduced enrichment in gene sets related to tumor immune microenvironment in Poor Prognosis and cell enrichment analysis confirmed significantly reduced numbers of macrophages M1, CD8 T cells, plasma cells and dendritic cells in samples in the Poor Prognosis samples compared with Good Prognosis. A subset of 742 genes derived from differential expression analysis as well as genes coding for immune checkpoint molecules was evaluated for their effect on overall survival. In conclusion, this study may contribute to the better understanding of breast cancer transcriptomics and provide possible targets for further research and eventual therapeutic interventions.
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Affiliation(s)
| | - Maria-Magdalena Mocanu
- Department of Biochemistry and Biophysics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Chandra S, Bhasin S, Saini S. A controversial ER negative PR positive molecular subtype of breast carcinoma-Report of two cases. Breast Dis 2023; 42:315-318. [PMID: 37807774 DOI: 10.3233/bd-230039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
ER-/PR+ is a controversial subtype and is not formally recognised as molecular subtype of breast carcinoma. Few studies concluded that this subtype does not exist and is due to technical errors, however, in contrast others consider it to be distinct entity with different response to therapy and clinical outcome. It is also essential to know whether this subtype shows any distinct histomorphological features or prognosis.Therefore, the present two cases of controversial subtype ER-/PR+ breast cancer is being reported with both the cases showing neuroendocrinal differentiation.
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Affiliation(s)
- Smita Chandra
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India
| | - Sanya Bhasin
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India
| | - Sunil Saini
- Department of Surgical Oncology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India
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Jiang X, Chen G, Sun L, Liu C, Zhang Y, Liu M, Liu C. Characteristics and survival in bone metastatic breast cancer patients with different hormone receptor status: A population-based cohort study. Front Oncol 2022; 12:977226. [PMID: 36091103 PMCID: PMC9459168 DOI: 10.3389/fonc.2022.977226] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Accumulating preclinical evidence has uncovered the indispensable role of steroid hormone and their receptors, namely, estrogen receptor (ER) and progesterone receptor (PR), in the development of bone metastases in breast cancer. Limited data are available regarding the survival difference between different hormone receptor (HR) subgroups, and its prognostic significance is uncertain now. Such data are important for risk stratification and needed to formulate specialized regimen for bone metastatic breast cancer. Methods From the year of diagnosis 2010 to 2018, 554,585 breast cancer patients, among which are 19,439 with bone metastasis and 10,447 with bone-only metastasis, were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier survival analysis was performed to compare the survival difference between the different HR status subgroups. Univariate and multivariate Cox proportional hazard regression was used to validate the prognostic role of HR status and identify other prognostic factors in bone metastatic breast cancer. Results ER-positive/PR-positive breast cancer patients with bone metastasis showed the best breast cancer-specific survival (BCSS) and overall survival (OS) than those with other HR statuses, while single PR-positive bone metastatic breast cancers manifest similar survival with ER-negative/PR-negative ones. Adjusted Cox regression analysis demonstrated that patients with older age, male, black race, ILC, higher tumor grade, T3–T4, HER2-negative status, absence of surgery or adjuvant treatment, and HR status other than ER-positive/PR-positive tended to have worse outcomes. Further subgroup analysis based on HER2 status showed that within HER2-positive breast cancers, ER-positive/PR-positive ones still manifest better survival than the other three HR status subgroups, which are similar in survival outcomes. Conclusion Although collectively viewed as HR-positive breast cancers, certain distinctions exist between bone metastatic breast cancers with different HR statuses in survival outcome. Our findings indicate that despite metastasizing to the same location, the different survival rate is determined by the HR status of breast cancer. The selection and intensity of the regimen should consider HR status, and HER2 status occasionally, when treating bone metastatic breast cancer.
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Affiliation(s)
- Xiaofan Jiang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
- Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guanglei Chen
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
- Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lisha Sun
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
- Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Liu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
- Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Zhang
- Department of Gastrointestinal Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Mingxin Liu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Caigang Liu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
- Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Caigang Liu,
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Zhu Y, Wang J, Xu B. A Novel Prognostic Nomogram for Predicting Survival of Hormone Receptor-Positive and HER2 Negative Advanced Breast Cancer Among the Han-Population. Front Oncol 2022; 12:918759. [PMID: 35847941 PMCID: PMC9285102 DOI: 10.3389/fonc.2022.918759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/30/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose To develop a nomogram model to predict overall survival in HR+/HER2- subtype advanced breast cancer. Methods A total of 3,577 ABC (advanced breast cancer) patients from 21 hospitals in China were involved in this study from January 2012 to December 2014. From all ABC patients, 1,671 HR+/HER2- ABC patients were extracted and enrolled in our study. A nomogram was built based on univariable and multivariable Cox regression analyses, identifying independent predictors. The discriminatory and predictive capacities of the nomogram were assessed using the ROC (receiver operating characteristic) curve and calibration plots. Results Univariable and multivariable analysis found that ER (estrogen receptor) status, MFIs (metastatic-free intervals), first-line therapy options, the number of metastatic sites, and whether local therapy for metastatic sites was chosen, were significantly related to overall survival (all P < 0.05). These variables were incorporated into a nomogram to predict the 2- year, 3-year, and 5-year OS (overall survival) of ABC patients. The AUC (the area under the curve) of the nomogram was 0.748 (95% CI (confidence interval):0.693-0.804) for 5-year OS in the training cohort and 0.732 (95% CI: 0.676-0.789) for the validation cohort. The calibration curves revealed good consistency between actual survival and nomogram prediction in the training and validation cohorts. Additionally, the nomogram showed an excellent ability to stratify patients into different risk cohorts. Conclusion We established a nomogram that provided a more straightforward predictive model for the outcome of HR+/HER2- ABC subtype patients and, to some extent, assisted physicians in making the personalized therapeutic option.
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Zhou Y, Zhou J, Xiao J, Wang Y, Wang H, Shi H, Yue C, Jia F, Li P, Hu Z, Yang Y, Jiang Z, Wang T. Prognostic Relevance of Estrogen Receptor Status in Circulating Tumor Cells in Breast Cancer Patients Treated With Endocrine Therapy. Front Oncol 2022; 12:866293. [PMID: 35574364 PMCID: PMC9097586 DOI: 10.3389/fonc.2022.866293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/25/2022] [Indexed: 12/21/2022] Open
Abstract
Recently, female breast cancer (BC) has surpassed lung cancer to occupy the first place of the most commonly diagnosed cancer. The unsatisfactory prognosis of endocrine therapy for breast cancer might be attributed to the discordance in estrogen receptor (ER) status between primary tumors and corresponding metastases, as well as temporal and spatial receptor status heterogeneity at point-in-time between biopsy and treatment. The purpose of this study was to evaluate the prognostic and predictive value of ER status in circulating tumor cells (CTCs) in BC patients. We analyzed ER expression on CTCs isolated using the Pep@MNPs method in 2.0 ml of blood samples from 70 patients with BC and 67 female controls. The predictive and prognostic value of ER expression in CTCs and immunohistochemistry results of biopsies for progression-free survival (PFS) and overall survival (OS) of patients in response to therapies were assessed. The detection rate for CTCs was 95.71% (67/70 patients), with a median of 8 CTCs within 2 ml of peripheral venous blood (PVB). A concordance of 76.56% in ER status between CTCs and corresponding primary tumor and 69.23% between CTCs and corresponding metastases was observed. We also found that patients with ER-positive CTCs (CTC ER+) had longer PFS and OS than those without ER-positive CTCs (CTC ER-). Our findings suggested that ER status in CTCs of BC patients may provide valuable predictive and prognostic insights into endocrine therapies, although further evaluation in larger prospective trials is required.
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Affiliation(s)
- Ying Zhou
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.,CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China
| | - Jinmei Zhou
- Breast Cancer Department, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Jinyi Xiao
- Breast Cancer Department, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Yuehua Wang
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China.,School of Pharmaceutical Science and Technology, Health Science Platform, Tianjin University, Tianjin, China
| | - Hao Wang
- Nanopep Biotech Co., Beijing, China
| | - Haoyuan Shi
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Chunyan Yue
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China
| | - Fei Jia
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China
| | - Ping Li
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China
| | - Zhiyuan Hu
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.,CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China.,School of Nanoscience and Technology, Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China.,School of Chemical Engineering and Pharmacy, Wuhan Institute of Technology, Wuhan, China
| | - Yanlian Yang
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, China.,School of Nanoscience and Technology, Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - Zefei Jiang
- Breast Cancer Department, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Tao Wang
- Breast Cancer Department, The Fifth Medical Center of PLA General Hospital, Beijing, China
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Kunc M, Pęksa R, Cserni G, Iżycka-Świeszewska E, Łacko A, Radecka B, Braun M, Pikiel J, Litwiniuk M, Pogoda K, Szwajkosz A, Biernat W, Senkus E. High expression of progesterone receptor may be an adverse prognostic factor in oestrogen receptor-negative/progesterone receptor-positive breast cancer: results of comprehensive re-evaluation of multi-institutional case series. Pathology 2022; 54:269-278. [PMID: 35074178 DOI: 10.1016/j.pathol.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
Oestrogen receptor (ER)-negative (-) progesterone receptor (PgR)-positive (+) is the least common combination of steroid receptor expression observed in breast cancer. There are many controversies regarding the actual existence of ER-/PgR+ phenotype. In the current study, we aimed to perform comprehensive immunohistochemical re-evaluation of ER-/PgR+ breast cancers from multiple institutions. A total of 135 cases of ER-/PgR+ breast cancer were collected from 11 institutions from the period 2006-2020 and subsequently stained with three clinically validated anti-ER antibody clones: SP1 (Roche), 1D5 (Dako), and EP1 (Dako), and two anti-PgR antibody clones: 636 (Dako), and 1E2 (Roche). Clinicopathological characteristics of confirmed and re-categorised cases were analysed. Seventy-six cases retained the original ER-/PgR+ phenotype, including 21 HER2+ and 55 HER2- tumours. Forty-seven cases were ER+ with at least one anti-ER antibody, and 12 cases were re-categorised as double-negatives across all anti-ER and anti-PgR antibodies. No significant differences in survival were observed between groups in the HER2+ category. In the HER2- cohort, confirmed ER-/PgR+, ER+ tumours with discrepant ER staining, and triple negatives had inferior overall survival compared to concordant ER+ cases. Progesterone receptor expression in >20% of cells was identified as an adverse prognostic factor in ER-/PgR+/HER2- breast cancer in a multivariable model adjusted by stage (HR 5.0, 95% CI 1.3-19.2, p=0.019). We performed one of the largest validation studies so far on ER-/PgR+ breast cancer and confirmed the existence of this subgroup. Moreover, we identified high PgR expression as an adverse prognostic factor.
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Affiliation(s)
- Michał Kunc
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland.
| | - Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Gabor Cserni
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary; Institute of Pathology, University of Szeged, Szeged, Hungary
| | - Ewa Iżycka-Świeszewska
- Department of Pathology and Neuropathology, Medical University of Gdańsk, Gdańsk, Poland
| | - Aleksandra Łacko
- Lower Silesian Oncology Centre, Breast Unit, Wroclaw, Poland; Department of Oncology, Wrocław Medical University, Wroclaw, Poland
| | - Barbara Radecka
- Department of Oncology, Institute of Medical Sciences, University of Opole, Opole, Poland; Tadeusz Koszarowski Cancer Center, Opole, Poland
| | - Marcin Braun
- Department of Pathology, Chair of Oncology, Medical University of Łódź, Łódź, Poland
| | | | - Maria Litwiniuk
- Greater Poland Cancer Centre, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Pogoda
- Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Szwajkosz
- Oncology Ward, Beskid Oncology Centre-John Paul II Municipal Hospital in Bielsko-Biała, Bielsko-Biała, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Elżbieta Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland.
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15
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Kunc M, Popęda M, Biernat W, Senkus E. Lost but Not Least-Novel Insights into Progesterone Receptor Loss in Estrogen Receptor-Positive Breast Cancer. Cancers (Basel) 2021; 13:cancers13194755. [PMID: 34638241 PMCID: PMC8507533 DOI: 10.3390/cancers13194755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/28/2022] Open
Abstract
Estrogen receptor α (ERα) and progesterone receptor (PgR) are crucial prognostic and predictive biomarkers that are usually co-expressed in breast cancer (BC). However, 12-24% of BCs present ERα(+)/PgR(-) phenotype at immunohistochemical evaluation. In fact, BC may either show primary PgR(-) status (in chemonaïve tumor sample), lose PgR expression during neoadjuvant treatment, or acquire PgR(-) phenotype in local relapse or metastasis. The loss of PgR expression in ERα(+) breast cancer may signify resistance to endocrine therapy and poorer outcomes. On the other hand, ERα(+)/PgR(-) BCs may have a better response to neoadjuvant chemotherapy than double-positive tumors. Loss of PgR expression may be a result of pre-transcriptional alterations (copy number loss, mutation, epigenetic modifications), decreased transcription of the PGR gene (e.g., by microRNAs), and post-translational modifications (e.g., phosphorylation, sumoylation). Various processes involved in the down-regulation of PgR have distinct consequences on the biology of cancer cells. Occasionally, negative PgR status detected by immunohistochemical analysis is paradoxically associated with enhanced transcriptional activity of PgR that might be inhibited by antiprogestin treatment. Identification of the mechanism of PgR loss in each patient seems challenging, yet it may provide important information on the biology of the tumor and predict its responsiveness to the therapy.
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Affiliation(s)
- Michał Kunc
- Department of Pathomorphology, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (M.K.); (W.B.)
| | - Marta Popęda
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (M.K.); (W.B.)
| | - Elżbieta Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, 80-214 Gdańsk, Poland
- Correspondence: ; Tel.: +48-58-584-4481
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