Difference Of Biological Markers Between Primary Tumor And Metastatic Axillary Lymph Node Of LuminalA Subtype Breast Cancer

Objective:The clinical develops treatment programs and predicts the prognosis of breast cancer mainly based on the molecular classification of primary breast cancer,ignoring the expression of lymph node metastasis phenotype markers.To study the difference of biological markers between primary tumor and metastatic axillary lymph node of Luminal A subtype breast cancer.Methods:Primary tumor tissue and metastatic lymph node specimens were obtained from 70 patients with Luminal A subtype breast cancer at Department of Breast Surgery,First Hospital of China Medical University,from March 1,2012-November 30,2014.All metastatic axillary lymph nodes were detected of four biomarkers including estrogen receptor(ER),progesterone receptor(PR),HER2,and KI-67 by immunohistochemistry.Results: The seventy cases of luminalA subtype primary tumor shifted to other subtype metastatic lymph nodes with worse prognostic in 23 of 70 cases(32.86%).ER was expressed inconsistently between the primary tumor and metastatic lymph node in 6cases of these patients,the change rate was 8.57%(6/70).PR was expressed inconsistently between the primary tumor and metastatic lymph node in 7 cases of these patients,the change rate was 10%(7/70).HER2 was expressed inconsistently between the primary tumor and metastatic lymph node in 8 cases,the change rate was 11.43%(8/70).KI-67 was expressed inconsistently between the primary tumor and metastatic lymph node in 12 cases,the change rate was 17.14%(12/70).The number of metastatic lymph node has positive correlation with the change of biological markers between primary tumor and metastatic lymph node,r=0.396,P=0.003.And also,The number of metastatic lymph node has positive correlation with the change of PR(r=0.279,P=0.042)and KI-67(r=0.405,P=0.003)index.Conclusions : LuminalA subtype primary tumor shifted to other subtype metastatic lymph nodes with worse prognostic in 23 of 70 cases(32.86%).At present,to develop a comprehensive treatment program only according to the primary tumor phenotype markers may be incomplete.The molecular subtypes in the metastatic nodes should betaken into account or using a more accurate method to assess the tumor in order to reduce tumor heterogeneity risk.