中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (2): 142-147.doi: 10.19401/j.cnki.1007-3639.2019.02.008

• 论著 • 上一篇    下一篇

中国BRCA1/2突变阳性和突变阴性乳腺癌病理学特征的比较性研究

朱信屹1,田 田2,蔡 旭2,秦广琪3,孙孟红3,吴 炅1,沈镇宙1,邵志敏1,胡 震1   

  1. 1. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    2. 复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系,上海200032 ;
    3. 复旦大学附属肿瘤医院组织库,复旦大学上海医学院肿瘤学系,上海200032
  • 出版日期:2019-02-28 发布日期:2019-03-25
  • 通信作者: 胡 震 E-mail: zhenhu@fudan.edu.cn

Comparative study on the pathological features of BRCA1/2 mutation and non-BRCA1/2 mutation breast cancers in China

ZHU Xinyi1, TIAN Tian2, CAI Xu2, QIN Guangqi3, SUN Menghong3, WU Jiong1, SHEN Zhenzhou1, SHAO Zhimin1, HU Zhen1   

  1. 1.Breast Cancer Institute, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Tissue Bank, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2019-02-28 Online:2019-03-25
  • Contact: HU Zhen E-mail: zhenhu@fudan.edu.cn

摘要: 背景与目的:BRCA1和BRCA2是两个最主要的遗传性乳腺癌相关基因,本研究旨在发现中国BRCA1/2突变阳性乳腺癌的病理学特征。方法:本研究入组了2012—2016年间287例接受过BRCA1/2基因突变检测的乳腺癌,对其中BRCA1/2突变阳性和突变阴性患者的组织病理学和免疫组织化学检测结果进行了比较性研究。结果:在287例乳腺癌中,66例为BRCA1突变阳性,47例为BRCA2突变阳性,174例为BRCA1/2突变阴性。BRCA1突变的乳腺癌表现为更高的组织学分级(P<0.001),更高比例的三阴性乳腺癌(72.7%,P<0.001)。BRCA1突变阳性和BRCA2突变阳性的乳腺癌中人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)的阳性表达率较BRCA1/2突变阴性的乳腺癌更低(P<0.001)。BRCA1突变阳性乳腺癌基底标志物细胞角蛋白5/6(cytokeratin 5/6,CK5/6)和表皮生长因子受体(epidermal growth factor receptor,EGFR)的阳性率为50%,明显高于其他两组(P<0.001),雄激素受体(androgen receptor,AR)的阳性率也更低(P<0.05)。结论:中国BRCA1突变阳性乳腺癌更多为三阴性乳腺癌,具有CK5/6和EGFR的阳性率更高等特点,并且BRCA1和BRCA2突变阳性乳腺癌中HER2受体阳性率也更低。

关键词: BRCA1基因, BRCA2基因, 乳腺癌, 病理学

Abstract: Background and purpose: BRCA1 and BRCA2 are two most common genes associated with hereditary breast cancers. Our research intended to discover the pathologic features of Chinese breast cancers with BRCA1/2 mutations. Methods: We included 287 breast cancers between 2011 and 2017, and BRCA1/2 germline mutation tests were carried out. The pathologic features of each patient were collected at Department of Pathology in Fudan University Shanghai Cancer Center for comparative study. Results: Of the 287 breast cancers, 66 cases were BRCA1 mutation positive, 47 cases were BRCA2 mutation positive and 174 cases were BRCA1/2 mutation negative. BRCA1 mutation breast cancer had higher nuclear grade tumors than the other two groups (P<0.001), 72.7% of BRCA1 mutation breast cancers were, whereas 25.5% of BRCA2 and 19.0% of non-BRCA1/2 mutation breast cancers were triple negative (P<0.001). BRCA1 and BRCA2 mutated breast cancers had lower human epidermal growth factor receptor 2(HER2) expression than non-BRCA1/2 mutated breast cancers (P<0.001). The positive expressions of cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor (EGFR) in BRCA1 mutation breast cancer were about 50%, significantly higher than those of the other two groups (P<0.001), and androgen receptor (AR) positive was less frequently seen in BRCA1 mutation breast cancers. Conclusion: These results suggest that BRCA1 mutation-associated breast cancers had clinical pathologic characteristics, such as triple negative, more positive CK5/6 or EGFR status. BRCA1/2 mutated breast cancers had lower HER2 expression.

Key words: BRCA1 gene, BRCA2 gene, Breast cancer, Pathology