Metastatik meme kanserli hastalarda HER-4 ekspresyonunun prognostik ve prediktif değerinin araştırılması
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Date
2012
Authors
Deligönül, Adem
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Meme kanseri, kadınlarda en sık görülen kanser türüdür. Son yıllarda meme kanserinde tedavi seçeneklerinin artmasına rağmen; histopatolojik özellikleri ve evreleri aynı olan ve benzer tedavileri alan hastalarda tedaviye yanıtın ve hastalığın seyrinin farklı olması prognostik faktörlerin önemini arttırmıştır. Bu çalışmada, metastatik meme kanserli kadın hastalarda Epidermal büyüme faktörü reseptörü ailesinden HER-4 `ün prediktif ve prognostik özelliğini degerlendirdik. Retrospektif olarak yapılan çalışmamızda invazif duktal karsinomlu olguların dosyaları tarandı. Parafin blokları patoloji arşivinden çıkarılarak, HER-4 ile immunhistokimyasal yöntemlerle boyandı. Membranöz, nükleer ve sitoplazmik boyanma sonucuna göre HER-4 pozitifliği RAJKUMAR skorlaması ile değerlendirildi. Çalışmamıza ortalama yaşı 50,5 ± 12,7 olan 45 olgu alındı. HER-4 pozitifliği %46 oranında bulundu. HER-4 pozitifliği ile incelenen parametreler arasında yalnız tümör lokalizasyonu ile ilişkili bulundu. Yaş, menapoz durumu, kemoterapi grubu, tümör boyutu, lenf düğümü tutulumu, gradı, östrojen veya progesteron reseptör pozitifliği, lenfovasküler invazyon, HER-2 veya Ki67 indeksi ile ilişkili bulunmadı. HER-4 pozitif olan olgularda genel sağ kalım ve progresyonsuz sağ kalım benzerdi. Çalışmamızda literatürle benzer olarak HER-4 pozitif olgularda hastalıklız sağ kalım istatiksel olarak anlamlı olmasada, HER-4 negatif olgulara göre daha yüksek olma eğilimindeydi. Genel olarak HER-4 ekspresyonu iyi prognostik bir veri olarak kabul edilebilir ve gelecekte HER-4 ile ilişkili tedaviler belirli meme kanseri hastalarının tedavisinde faydalı etki sağlayabilir.
Breast cancer is the most common type of cancer in women. Despite improvement in treatment choices in the last years, patients with similar histopahtological features and stages show different treatment responses and prognoses. This finding increased the importance of prognostic factors. In this study we assessed the predictive and prognostic features of HER-4 from the epidermal growth factor receptor family in patients with metastatic breast cancer. In this retrospective study the files of patients with invasive ductal carcinoma were analyzed. Paraffin blocks were obtained from the pathology archive and immunohistochemistry staining with HER-4 was performed. HER-4 positivity was investigated according to RAJKUMAR scoring due to membranous, nuclear and cytoplasmic staining pattern. Forty five patients were enrolled to our study. Mean age was 50.5 ± 12.7 years. HER-4 positivity was 46%. HER-4 positivity was associated only with tumor localization. There was no association between HER-4 positivity and age, menopause state, chemotherapy group, tumor size, lymph node involvement, grade, estrogen or progesterone receptor positivity, lymphovascular invasion, HER-2 positivity or Ki67 index. The general and progression free survival was similar between HER-4 positive and negative patients. However, in accordance with the literature relapse free survival was better in HER-4 positive patients compared to HER-4 negative patients, although the difference was not statistically significant. In general, HER-4 positivity may be considered a good prognostic feature and future treatment choices related to HER-4 may be beneficial in certain patients with breast cancer.
Breast cancer is the most common type of cancer in women. Despite improvement in treatment choices in the last years, patients with similar histopahtological features and stages show different treatment responses and prognoses. This finding increased the importance of prognostic factors. In this study we assessed the predictive and prognostic features of HER-4 from the epidermal growth factor receptor family in patients with metastatic breast cancer. In this retrospective study the files of patients with invasive ductal carcinoma were analyzed. Paraffin blocks were obtained from the pathology archive and immunohistochemistry staining with HER-4 was performed. HER-4 positivity was investigated according to RAJKUMAR scoring due to membranous, nuclear and cytoplasmic staining pattern. Forty five patients were enrolled to our study. Mean age was 50.5 ± 12.7 years. HER-4 positivity was 46%. HER-4 positivity was associated only with tumor localization. There was no association between HER-4 positivity and age, menopause state, chemotherapy group, tumor size, lymph node involvement, grade, estrogen or progesterone receptor positivity, lymphovascular invasion, HER-2 positivity or Ki67 index. The general and progression free survival was similar between HER-4 positive and negative patients. However, in accordance with the literature relapse free survival was better in HER-4 positive patients compared to HER-4 negative patients, although the difference was not statistically significant. In general, HER-4 positivity may be considered a good prognostic feature and future treatment choices related to HER-4 may be beneficial in certain patients with breast cancer.
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Keywords
Metastatik meme kanseri, HER-4, Prognoz, Metastatic breast cancer, Prognosis
Citation
Deligönül, A. (2012). Metastatik meme kanserli hastalarda HER-4 ekspresyonunun prognostik ve prediktif değerinin araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.