| Objective:Luminal subtype breast cancer is defined as estrogen receptor(ER) and/or progesterone receptor (PR) positive breast cancer. We detected the expression of ER-a, ER-β1 and ER-β2 in the tissue samples of invasive luminal subtype breast cancer patients, evaluated the correlations between these ER status and patients prognosis, and tried to make it clear that whether the ER-βstatus provides clinically useful information over what is already provided by the traditional ER-a/PR assay.Methods:The data of 162 invasive luminal subtype breast cancer patients, who received operation in Cancer Hospital of Chinese Academy of Medical Science from January 1st to September 30th in 2002, were collected and retrospectively analyzed. The expression of ER-a, ER-β1 and ER-β2 in the paraffin embedded sections were detected with immunohistochemical staining method. With mid-long term follow-up, the features of ER-a, ER-β1 and ER-P2 status and the correlations between clinical characteristics and the prognosis were analyzed.Results:Positive staining of ER-a in evaluable cases accounted for 86.2%(131/152), ER-β1 26.8%(40/149) and ER-β2 24.3%(35/144). Co-expression of ER-a/ER-β1 in evaluable cases accounted for 25.2%(37/147), ER-a/ER-β2 22.2%(32/144), ER-β1/ER-β2 7.7%(11/143) and ER-a/ER-β1/ER-β2 7.7%(11/143). ER-a status was negative correlated to p53 and tumor grade (rs=-0.207, P<0.05 and rs=-0.307, P<0.01, respectively), ER-β1 positive correlated to PR (rs=0.217, P<0.01). No correlations were found between ER-β2 and other clinical parameters (P>0.05). By March 31st 2010, the median time of follow-up was 92 months (range,4-98months).41 cases presented local recurrence or metastasis. The accumulated desease-free survival rate was 73.1%, and 5-year accumulated desease-free survival rate was 79.6%; 27 patients died of breast cancer and the mean survival time were 79.7 months. The accumulated overall survival rate was 82.5%, and the 5-year overall survival rate was 85.3%.Univariate analysis suggest that ER-β1 status was significantly correlated to disease-free survival time (Log Rank=3.98, P=0.046), especially in patients with positive lymph nodes (Log Rank=6.20,P=0.013). In patients with smaller tumor size (≤20mm), negative ER-(32 status was significantly correlated to overall survival time (Log Rank=3.87, P=0.049). Multivariate analysis was conducted. Without considering the influence of ER-β1 and ER-β2, PR status (HR=0.633, P=0.038,95.0%CI:0.411-0.976) and PCNA status (HR=1.823,P=0.045, 95.0%CI:10.12-3.283) were independent prognosis factors correlated to overall survival time, and PR status (HR=0.627,P=0.006,95.0%CI:0.448-0.877) was independent prognosis factors correlated to disease-free survival time. When taking ER-β1 and ER-β2 accounted, smaller tumor size (<20mm) and lymph node status were independent prognosis factors which were correlated to overall survival time (HR=8.931,P=0.032, 95.0%CI:1.203-66.285 and HR=2.806, P=0.040,95.0%CI: 1.051-7.493, respectively); Smaller tumor size (≤20mm), lymph node status and tumor grade were independent prognosis factors which were correlated to disease-free survival time (HR=3.206, P=0.029,95.0%CI:1.130-9.095;HR=2.998, P=0.006,95.0%CI: 1.366-6.535 and HR =1.950,P=0.027,95.0%CI:1.081-3.517, respectively).Conclusion:In invasive luminal subtype breast cancers, ER-β1 is correlated to fine prognosis, and could be regarded as one of the factors for evaluating DFS time, especially in lymph node positive patients. There may be some interactions between ER-β1 and PR. The functions of ER-β2 in invasive luminal subtype breast cancers are not clear yet. Further studies are needed to confirm our findings. In clinical practice, besides routine detection of ER-a and PR in invasive luminal subtype breast cancers, immunohistochemical staining of ER-β1 and ER-β2 should be considered in order to achieve more useful information.
|
PDF Full Text Request