Clinical study on molecular subtypes in breast ductal carcinoma in situ

doi:10.3877/cma.j.issn.1674-0807.2017.05.002

Abstract

Abstract:

Objective

To study the relationship of different histological grades and molecular subtypes with clinicopathological characteristics in breast ductal carcinoma in situ (DCIS) patients.

Methods

The surgical specimens from 240 patients with DCIS in Guangdong Women and Children's Hospital from January 2001 to January 2016 were collected for a retrospective study. The expressions of ER, PR, HER-2 and Ki67 were detected by immunohistochemistry. Based on the results, all patients were divided into 4 molecular subtypes. The clinicopathological characteristics of DCIS patients were analyzed according to different histological grades and molecular subtypes. The data on age and histological grade were compared by nonparametric test (Kruskal-Wallis H test), and the other indexes were analyzed by χ² test. χ² segmentation was used for pairwise comparison in ER, PR and HER-2 expression.

Results

Among the 240 patients, there were 74 cases (30.8%) of low-grade DCIS, 139 cases (57.9%) of middle-grade DCIS and 27 cases(11.3%) of high-grade DCIS. There were 92 cases (38.3%) of luminal A subtype, 70 cases (29.2%) of luminal B subtype, 76 cases (31.7%) of HER-2-overexpressed subtype and 2 cases (0.8%) of triplenegative subtype. The age distribution showed no significant difference in DCIS patients at different histological grades (χ²=5.224,P=0.073), but there were significant differences in ER, PR and HER-2 expressions(χ²=62.974,59.391,58.501; all P<0.001). The results of pairwise comparison showed that the expression of ER/PR in low-grade DCIS was significantly higher than that in middle-grade or high-grade DCIS (ER: χ²=36.345,67.769,both P<0.014;PR: χ²=41.172, 51.440,both P<0.014), while the expression of HER-2 in high-grade DCIS was significantly higher than that in middle-grade or low-grade DCIS(χ²=6.391,50.132,both P<0.014). There was no significant difference in age distribution and affected side among patients with different molecular subtypes (χ²=0.811,4.332; P=0.847,0.228), while the histological grade showed a significant difference(χ²=80.779,P<0.001). The histological grades were significantly different comparing luminal A subtype with luminal B, HER-2-overexpressed and triple-negative subtypes respectively (all P<0.050). The histological grade of luminal B subtype was significantly different from that of HER-2-overexpressed subtype (P<0.050).

Conclusion

The molecular typing can be used as a reference for clinical diagnosis and prognosis prediction in DCIS patients.

Key words: Breast neoplasms, Ductal carcinoma in situ, Molecular classification, Immunohistochemistry

Wenjing Chen, Jiangyu Zhang, Zhongyang Chen, Kunhe Wu, Hongyi Gao, Huijuan Lin. Clinical study on molecular subtypes in breast ductal carcinoma in situ[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(05): 262-265.

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URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2017.05.002

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分子分型	免疫组织化学表达
luminalA型	ER阳性、PR阳性、HER-2阴性、Ki67＜14%
luminalB型	ER阳性、PR阳性、HER-2阳性或ER阳性、PR阳性、HER-2阴性、Ki67≥15%或PR阴性
HER-2过表达型	ER阴性、PR阴性、HER-2阳性
三阴型	ER、PR、HER-2均为阴性

分子分型	免疫组织化学表达
luminalA型	ER阳性、PR阳性、HER-2阴性、Ki67＜14%
luminalB型	ER阳性、PR阳性、HER-2阳性或ER阳性、PR阳性、HER-2阴性、Ki67≥15%或PR阴性
HER-2过表达型	ER阴性、PR阴性、HER-2阳性
三阴型	ER、PR、HER-2均为阴性

临床病理特征	导管原位癌			χ ²值	P值
临床病理特征	低级别 (n=74)	中级别 (n=139)	高级别 (n=27)	χ ²值	P值
年龄^a
＜40岁	27	34	4	5.224	0.073
40~55岁	34	84	23
56~70岁	5	14	0
＞70岁	8	7	0
ER^b
阳性	72	81	5	62.974	＜0.001
阴性	2	58	22	62.974	＜0.001
PR^c
阳性	66	61	4	59.391	＜0.001
阴性	8	78	23	59.391	＜0.001
HER-2^d
阳性	7	77	22	58.501	＜0.001
阴性	67	62	5	58.501	＜0.001

临床病理特征	导管原位癌			χ ²值	P值
临床病理特征	低级别 (n=74)	中级别 (n=139)	高级别 (n=27)	χ ²值	P值
年龄^a
＜40岁	27	34	4	5.224	0.073
40~55岁	34	84	23
56~70岁	5	14	0
＞70岁	8	7	0
ER^b
阳性	72	81	5	62.974	＜0.001
阴性	2	58	22	62.974	＜0.001
PR^c
阳性	66	61	4	59.391	＜0.001
阴性	8	78	23	59.391	＜0.001
HER-2^d
阳性	7	77	22	58.501	＜0.001
阴性	67	62	5	58.501	＜0.001

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