雌,孕激素受体与乳腺癌内分泌治疗的抵抗

雌、孕激素受体与乳腺癌内分泌治疗的抵抗张蕾巩平综述孙素莲审校北京医科大学临床肿瘤学院北京市肿瘤防治研究所（北京市１０００３４）雌激素受体（Ｅｓｔｒｏｇｅｎｒｅｃｅｐｔｏｒ，ＥＲ）和孕激素受体（Ｐｒｏｇｅｓｔｅｒｏｎｅｒｅｃｅｐｔｏｒ，ＰＲ）在乳腺癌的...     

对乳腺癌雌孕激素受体检测的认识

自从1896年英国医师Beatson博士应用双侧卵巢切除治疗晚期乳腺癌首获成功、开启内分泌治疗乳腺癌的大幕,迄今已有一百多年了。而ER、PR的发现及其与乳腺癌患者预后的相关性,以及应用ER、PR筛选内分泌治疗优势人群,又把乳腺癌的内分泌治疗推上了新的水平高度。     

乳腺癌肿瘤组织不同部位雌孕激素受体的表达

目的 探讨乳腺浸润性导管癌肿瘤组织中不同部位雌、孕激素受体表达情况.方法 收集32例手术切除乳腺浸润性导管癌肿瘤标本,于每例肿瘤标本4个不同部位取材,用免疫组化方法检测各部位雌、孕激素受体表达情况.结果 肿瘤组织不同部位雌、孕激素受体检测结果一致性好,最好Kappa值分别为0.789和0.810,最差Kappa值分别为...     

耐药基因及雌孕激素受体在乳腺癌中的表达及意义

本文用免疫组化法对１５例乳腺癌做了多药耐药基因产物Ｐ１７０及谷胱甘肽Ｓ－转移酶（ＧＳＴπ）以及雌孕激素受体（ＥＲ，ＰＲ）的检测。浸润性导管癌１４例，粘液腺癌１例。检测结果雌孕激素受体共同表达率为６６．７％（１０／１５），Ｐ１７０过度表达为６６．７（１０／１５），ＧＳＴπ过度表达为５５．３％（８／１５）。ＥＲ、ＰＲ表达与肿瘤的分化程度有关，即分化好的乳腺癌标记率较高，提示预后较好。结果表明多数乳腺癌     

乳腺肿瘤雌、孕激素受体表达与细胞增殖

目的：观察乳腺肿瘤雌、孕激素受体表达与细胞增殖的关系。方法：用免疫细胞化学技术（ＡＢＣ法）对经病理确诊２５５例恶性和６６０例良性乳腺肿瘤进行了ＥＲ、ＰＲ、ｃ－ｅｒｂＢ－２、ｐ５３基因蛋白表达和Ｋｉ－６７抗原检测。结果：良、恶性乳腺肿瘤间,ＥＲ、ＰＲ阳性率均有极显著差异。良性肿瘤组中,ＥＲ＋ＰＲ＋组和ＥＲ－ＰＲ－组间差异有显著性;ｐ５３表达率在ＥＲ、ＰＲ阴、阳性组间差异有显著性;ｃ－ｅｒｂＢ－２表达     

100例乳腺癌雌激素和孕激素受体的测定和分析

目前临床医生根据对乳腺癌雌激素受体（ＥＲ）和孕激素受体（ＰＲ）测定来指导治疗方案。Ｗｉｔｌｉｆ综合文献报道ＥＲ和ＰＲ阳性时进行内分泌治疗有效率达７８％,而ＥＲ和ＰＲ阴性时仅１０％,有明显的差异性［１］。故对乳腺癌组织中ＥＲ和ＰＲ测定,有助于治疗方案的...     

耐药基因及雌孕激素受体在乳腺癌中的表达及意义

本文用免疫组化法对15例乳腺癌做了多药耐药基因产物P17。及谷航计肽S一转移酶（GST。）以及雌孕激素受体（ER，PR）的检测。浸润性导管瘤14例，粘液腺癌1例。检测结果雌孕激素受体共同表达率为667％（IO门5），巳？。过度表达为“7（10／15）．GSTx过度表达为553％（8／15）。ER、PR表达与肿瘤的分化程度有关，即分化好的乳腺癌标记率较高，提示预后较好。结果表明多数乳腺癌表达雌孕激素受体，提示对内分泌治疗有效。P；0，GST，不仅为乳腺癌标记物，而且也提示了多数乳腺癌对亲脂类及烷化剂类化疗药可能具有耐药性。因此时过度表达的乳腺癌临床上应慎用此类化疗药。     

脑膜瘤的雌孕激素受体

本文对３３例脑膜瘤的ＥＲ，ＰＲ作了分析。脑膜瘤性激素受体的阳性率：ＥＲｃ为０，ＥＲｎ为６．１％，ＰＲｃ为１２．１％，ＰＲｎ为６３．３％。多数肿瘤中测不到ＥＲ，且测到者含量变极低。ＰＲ含量明显高于ＥＲ，认为脑膜瘤以ＰＲ占优势。ＰＲ与ＥＲ间无相关关系，ＥＲｎ（ｇ ），ＰＲｎ（＋）者明显多于ＥＲｎ（＋），ＰＲｎ（＋）者，提示脑瘤的ＰＲ可能是一个不依赖于ＥＲ调节的独立系统。本资料为脑膜瘤的激素治疗可能性提     

乳腺癌雌、孕激素受体与腋淋巴结转移的关系

目的探讨乳腺癌雌、孕激素受体(ER、PR)与淋巴结转移之间的关系.方法应用免疫组织化学方法对257例乳腺癌组织石蜡切片进行ER、PR检测,将ER、PR结果与病理检出淋巴结的结果进行统计学分析.结果 ER、PR的阳性表达率分别为63.27%和59.27%.在ER、PR的4种组合中淋巴结转移率基本相同,经统计学处理均无显著差异(P＞0.05).结论乳腺癌组织中的ER、PR阳性表达与淋巴结转移无关.ER、PR测定对指导内分泌治疗和估计预后有重要意义.     

Prognostic Significances of Estrogen and Progesterone Receptors in Primary Operable Breast Cancer

Both estrogen and progesterone receptors have been determinedin 613 primary breast cancer patients treated by radical mastectomy.At the cut-off value of 5 fentomoles (fmol) cytosol pro-tein/mgfor both receptors, patients with estrogen or progesterone receptor-positivebreast cancer showed significantly favorable disease-free, overalland post-recurrence survival curves to those of receptor-negativebreast cancer patients. In the patient subgroups: premenopausal,stage III, more than four positive lymph node metastases, postoperativeadjuvant tamoxifen therapy, a significantly favorable prognosiswas recognized in either estrogen or progesterone receptor-positivepatients. Both receptors are thought to be useful prognosticindicators for patients with advanced tumors or for those receivingpostoperative adjuvant tamoxifen therapy. When the cut-off valuewas changed, the maximum significant difference in prognosisbetween receptor-positive and receptor-negative patients wasobserved at 5 fmol cytosol protein/mg for the estrogen receptoror 10 fmol/mg cytosol protein for the progesterone receptor.A more detailed examination should be made on the cut-off valuesof both receptors.     

胃癌109例雌激素受体与孕激素受体的检测研究

自１９８６～１９９３年采用李氏荧光雌激素组织化学法对胃癌１０９创作了雌激素受体（ＥＲ）、孕激素受体（ＰｇＲ）测定，同时对８例非肿瘤病人的胃正常粘膜作了ＥＲ、ＰｇＲ测定。１０９例胃癌的ＥＲ、ＰｇＲ阳性率分别为２３％、２７．５％，８例非肿瘤病人的胃正常粘膜ＥＲ、ＰｇＲ均阴性。１０９例胃癌中高分化腺癌ＥＲ、ＰｇＲ阳性率分别为４４．１％（１５／３４）、４７．１％（１６／３４），均明显高于低分化腺癌的１４％（６／４３）及２０．９％（９／４３），ＥＲ为Ｐ＜０．０２、ＰｇＲ为Ｐ＜０．０５，发病年龄及性别与ＥＲ、ＰｇＲ均无关。认为ＥＲ、ＰｇＲ阳性的胃癌与雌激素靶器官的恶性肿瘤一样，可能为雌激素依赖性肿瘤，对内分泌治疗有着良好的前景。     

Analysis of Cytosol CA15-3, Carcinoembryonic Antigen, Estrogen and Progesterone Receptors in Breast Cancer Tissues

Cytosol levels of carcinoembryonic antigen (CEA), CA15-3, estrogen receptor (ER) and progesterone receptor (PgR) of 194- primary breast cancer tissues were measured. ER and PgR determined by enzyme immunoassay methods correlated inversely with Page's grades of histological atypia and mitotic rate. Cytosol CA15-3 correlated inversely with the grades of tubular and nuclear atypia and positively with the mitotic rate. CA15-3 correlated positively with ER and PgR. Cytosol CEA showed no correlation with the pathological grade or hormone receptor status. These results indicate that hormone receptor-positive breast cancers tend to have more differentiated morphology and slower growth rate than those without those receptors and that the cytosol CA15-3 level may reflect some of the intrinsic malignant potency, particularly the growth rate, of breast cancer. Cytosol CA15-3 as well as the hormone receptor status may have prognostic value for patients with breast cancer.     

乳腺癌组织中孕激素受体与雌激素受体DNA结合功能关系的研究

目的：观察３６例（Ｅ２＋）乳腺癌患者组织ＰＲ和ＥＲ ＤＮＡ结合功能的关系,进而探讨（Ｅ２＋／ＰＲ＋）表型内分泌治疗无反应的分子机制。方法：用激素结合法和迁移率改变法。结果：１）用含有ＥＲ的ＭＣＦ－７细胞株作为阳性对照,２２℃Ｍｇ＾２＋存在条件下,迁移率改变法中ＥＲ－ＥＲＥ复合物的形成是激素依赖性的,证实了ＥＲ－ＥＲＥ复合物的特性。（２）激素结合法和迁移率改变法检测结果显示,３６例（Ｅ２＋）乳腺癌中     

Survival Benefit of Tamoxifen in Estrogen Receptor-Negative and Progesterone Receptor-Positive Low Grade Breast Cancer Patients

Purpose

This study aimed to analyze the efficacy and prognostic significance of adjuvant tamoxifen in breast cancer patients with various hormone receptor statuses.

Methods

Typically, 1,260 female breast cancer patients were recruited in this study. The correlation between estrogen receptor (ER)/progesterone receptor (PR) phenotypes and clinical characteristics was investigated, and the survival rate was assessed after 5-year follow-up.

Results

The 5-year overall survival (85%) was better in women under the age of 50 years. Patients with ER+/PR+ tumors had a better 5-year survival rate (94%); those with ER-/PR- tumors experienced the worst outcome (74% survival rate); whereas single-positive cases were in between. In 97 out of 128 patients with ER-/PR+ tumors, tamoxifen was given as adjuvant hormonal therapy, and it increased the survival benefit in the lower grade group in terms of overall survival and disease-free survival (p=0.01 and p=0.03, respectively).

Conclusion

For high-grade tumors with ER-/PR+, adjuvant tamoxifen therapy may have no survival benefit, whereas for the patients with low-grade ER-/PR+ tumors, adjuvant tamoxifen therapy is highly suggestive.     

人乳腺癌雌激素受体和孕酮受体与外周血性激素水平的关系

测定了30例未绝经和73例的绝经后乳腺癌妇女的雌激素受体(ER)、孕酮受体(PR)和外周血雌酮(E_1)、雌二醇(E_2)、孕酮(P)和睾酮(T)水平。结果表明:(1)乳腺癌病人外周血E_1和P水平在ER_ 组和ER PR-组明显高于ER-组和ER-PR-组(P<0.05)。(2)乳腺癌病人外周血E_2水平在PR 组和ER~ PR~ 组明显高于PR-组和ER-PR-组(3)乳腺癌病人术后生存期与外周血T水平有关,ER-组和PR-组乳腺癌病人中,术后生存期≥5年组和术后生存期<5年组之间外周血T水平有显著差异(P<0.05,P<0.001)。     

12种凝集素与雌激素和孕激素受体在乳腺癌中的对比研究

本文应用亲和组化法对100例乳腺癌的12种凝集素受体与ER和PR进行对比研究,结果发现:(1)PNA-R与ER阳性符合率91.2％;RCA-R与PR为88.5％。(2)PNA-R与ER,RCA-R与PR在乳腺癌各年龄组、月经状况、肿瘤大小、淋巴结转移和各组织学类型的阳性率呈正相关。(3)PNA-R、ER、RCA-R、PR阳性患者肿瘤的复发率低于阴性患者(P<0.05)。结果提示乳腺癌PNA-R与ER,RCA-R与PR有一致性,可通过亲和组化法对常规石蜡切片测定乳腺癌PNA-R和RCA-R,以推测乳腺癌患者的ER和PR状况,对指导临床估计预后和内分泌治疗有重要意义。     

大肠癌组织雌激素与孕酮受体检测的初步探讨

本文应用亲和酶标法检测了87例大肠癌组织及80例乳腺癌组织的雌激素受体(ER)和孕酮受体(PR),结果大肠癌的ER、PR阳性率分别为62.1％和46.0％;乳腺癌的ER、PR阳性率分别为65％和56.3％.大肠癌ER、PR阳性率与病人性别、肿瘤部位无关,而绝经后的大肠癌患者,年龄越大,肿瘤分化程度越高,受体阳性率亦越高,与乳腺癌相类似.提示大肠癌与乳癌一样为雌激素依赖性肿瘤,可试行内分泌治疗.