Difference in expression of molecular markers between primary lesions and recurrent/metastatic lesions and transformation of molecular subtypes in breast cancer patients in XinJiang region

doi:10.3877/cma.j.issn.1674-0807.2020.04.007

Abstract

Abstract:

Objective

To investigate the expression differences of molecular markers ER, PR, HER-2, Ki67 and p53 between primary lesions and recurrent/metastatic lesions and molecular subtype transformation in breast cancer patients in Xinjiang region.

Methods

This study was a two-way cohort study. The female breast cancer patients with first local recurrence or distant metastasis in the Affiliated Cancer Hospital of Xinjiang Medical University from May 2017 to May 2019 was enrolled in this study. The expression of ER, PR, HER-2, Ki67, and p53 in recurrent/metastatic lesions was detected with the samples obtained by surgery or aspiration biopsy. Meanwhile the clinical data of patients before recurrence or metastasis was retrospectively analyzed to extract the expression of ER, PR, HER-2, Ki67, and p53 in primary lesions. The paired χ² test was used to compare the expressions of ER, PR, HER-2, Ki67, and p53 between recurrent/metastatic lesions and primary lesions.

Results

Totally 103 patients were enrolled. In primary lesions, the positive rates of ER, PR, HER-2 and p53 were 63.1%(65/103), 55.3%(57/103), 31.1%(32/103)and 68.9%(71/103), and the high expression of Ki67 (>14%) accounted for 68.93%(71/103)of the total. In recurrent/metastatic lesions, the positive rates of RR, PR, HER-2 and p53 in recurrent/metastatic lesions were 56.3%(58/103), 42.7%(44/103), 30.1%(31/103)and 77.7%(80/103), and the high expression of Ki67 accounted for 68.9%(71/103)of total. The rates of expression change of ER, PR, HER-2, Ki67 and p53 were 8.7%(9/103), 16.5%(17/103), 6.8%(7/103), 29.1%(30/103)and 14.6%(15/103). There was no significant difference in the expression of HER-2 and Ki67 between recurrent/metastatic lesions and primary lesions (P=1.000, 1.000), while the expression of ER, PR and p53 presented a significant difference (P=0.039, 0.002, 0.035). In 103 patients, luminal A, luminal B, HER-2 overexpression and triple negative subtypes in primary lesions and recurrent/metastatic lesions accounted for 8.7% (9/103) and 10.7% (11/103), 54.3% (56/103) and 53.4% (55/103), 18.4% (19/103) and 14.6% (15/103), 18.4% (19/103) and 21.4% (22/103), respectively. After recurrence and metastasis, the proportion of luminal A and triple-negative subtypes increased, and the proportion of other molecular subtypes decreased. Then 6/9, 30.4% (17/56), 7/19, 3/19 of luminal A, luminal B, HER-2 overexpression, and triple-negative subtypes in primary lesions were transformed into other subtypes after recurrence and metastasis.

Conclusions

Gene expression often changes after recurrence and metastasis of breast cancer, and the molecular subtype transformation is common. Through the molecular expression and molecular subtype of recurrent and metastatic lesions, we can develop more accurate treatment schemes to improve the therapeutic effect.

Key words: Breast neoplasms, Neoplasm recurrence, local, Neoplasm metastasis, Gene expression

Zhenhui Zhao, Yan Li, Wei Liu, Xiaoping Ma, Hongyu Li, Li Li, Chunyan Gao, Dan Liu, Xun Li. Difference in expression of molecular markers between primary lesions and recurrent/metastatic lesions and transformation of molecular subtypes in breast cancer patients in XinJiang region[J]. Chinese Journal of Breast Disease(Electronic Edition), 2020, 14(04): 234-239.

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