科研之友
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摘要
The objectives of this study were to determine the prognostic significance of subgrouping estrogen receptor (ER)-positive breast tumors into low- and high-risk luminal categories using Ki67 index, TP53, or progesterone receptor (PR) status. The study group comprised 540 patients with, lymph node negative, invasive breast carcinoma. Lumina! A subtype was defined as being ER positive, HER2 negative, and Ki67 low (%26lt;14% cells positive) and lumina! B subtype as being ER positive, HER2 negative, and Ki67 high (%26gt;= 14% cells positive). Luminal tumors were also subgrouped into risk categories based on the PR and TP53 status. Survival analysis was performed. Patients with luminal B tumors (n = 173) had significantly worse disease-free survival compared to those with luminal A tumors (n = 186) (log rank P-value = 0.0164; univariate Cox regression relative risk 2.00; 95% Cl, 1.12-3.58; P = 0.0187). Luminal subtype remained an independent prognostic indicator on multivariate analysis including traditional prognostic factors (relative risk 2.12; 95% Cl, 1.16-3.88; P = 0.0151). Using TP53 status or PR negativity rather than Ki67 to classify ER-positive luminal tumors gave similar outcome results to those obtained using the proliferation index. However, it was a combination of the three markers, which proved the most powerful prognostically. Ki67 index, TP53 status, or PR negativity can be used to segregate ER-positive, HER2-negative tumors into prognostically meaningful subgroups with significantly different clinical outcomes. These biomarkers particularly in combination may potentially be used clinically to guide patient management.
- 出版日期2014-4
