grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russiagrekov-2197Research ArticleВОПРОСЫ ОБЩЕЙ И ЧАСТНОЙ ХИРУРГИИPROBLEMS OF GENERAL AND SPECIAL SURGERYСравнительная оценка прогностической значимости молекулярных маркеров опухоли (рецепторы эстрогенов и прогестерона, HER-2/neu) и Ноттингемского прогностического индекса при раке молочной железыComparative evaluation of the prognostic significance of molecular tumor markers (estrogen and progesterone receptors, HER-2/neu) and the Nottingham prognostic index in breast cancerhttps://orcid.org/0000-0002-9951-6917SekhriV.SekhriV.

Шри-Амритсар

Vineet Sekhri, Junior Resident, Department of General Surgery

Amritsar

vineetsekhri@ymail.comKapoorS.JainN.

Шри-Амритсар

Neeraj Jain, Department of Oncology

Amritsar

JainN.KapoorS.

Шри-Амритсар

Sudershan Kapoor, Professor and Head, Department of General Surgery

Amritsar

Университет медицинских наук Шри Гуру Рам ДасаИндияSri Guru Ram Das University of Health SciencesIndia20232908202318231117Copyright © Sekhri V., Kapoor S., Jain N., 20242024Sekhri V., Kapoor S., Jain N.Sekhri V., Jain N., Kapoor S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2197ВВЕДЕНИЕ

ВВЕДЕНИЕ. Ноттингенский прогностический индекс (НПИ) – это инструмент, который на основании количественных гистологических характеристик опухоли позволяет оценить прогноз заболевания и выработать оптимальную тактику лечения больных, страдающих раком молочной железы (РМЖ). Уровень рецепторов эстрогенов и прогестерона (ЭР/ПР), а также экспрессия рецепторов HER-2/neu являются важными параметрами молекулярной оценки данной опухоли.

ЦЕЛЬ

ЦЕЛЬ. Рассчитать НПИ у первичных больных РМЖ и сравнить прогностическую эффективность молекулярных маркеров (ЭР/ПР) с Ноттингемским прогностическим индексом.

МЕТОДЫ И МАТЕРИАЛЫ

МЕТОДЫ И МАТЕРИАЛЫ. В исследование включены 125 больных с ранним РМЖ. Ноттингемский прогностический индекс рассчитан на основании данных патоморфологических заключений, а уровни молекулярных маркеров получены путем иммуногистохимического анализа. Выполнено сравнение прогностической эффективности молекулярных маркеров с НПИ.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. По данным иммуногистохимического анализа ЭР-позитивные опухоли выявлены у 66 (53 %) больных, ПР-позитивные – у 55 (44 %), высокий уровень экспрессии рецепторов HER-2/neu зарегистрирован в 22 (18 %) случаях. Среднее значение НПИ составило 4,99±1,23. Было обнаружено, что молекулярные маркеры, соответствующие отличному прогнозу, согласно Ноттингемскому прогностическому индексу были отнесены к группе умеренного прогноза. При сравнении молекулярных маркеров с Ноттингемским прогностическим индексом не было обнаружено статистически значимых результатов, которые помогли бы в оценке прогноза (p>0,05).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. При раке молочной железы Ноттингемский прогностический индекс является более точным инструментом для оценки прогноза, чем иммуногистохимические маркеры.

INTRODUCTION. The Nottingham prognostic index (NPI) is a tool that, based on quantitative histological features of the tumor, allows optimal treatment tactics for patients suffering from breast cancer (BC). The level of estrogen and progesterone receptors (ER/PR), as well as the expression of HER-2/neu receptors are important parameters in the molecular evaluation of this tumor. The OBJECTIVE was to calculate the NPI in newly diagnosed patients with BC and to compare the prognostic efficacy of molecular markers (ER, PR) and Nottingham prognostic index. METHODS AND MATERIALS. The study included 125 patients with early BC. The Nottingham prognostic index was calculated based on the data of pathomorphological conclusions, and the levels of molecular markers were obtained by immunohistochemical analysis. Prognostic efficacy of molecular markers and Nottingham prognostic index was compared. RESULTS. According to immunohistochemical analysis, ER-positive tumors were detected in 66 (53%) patients, PRpositive – in 55 (44%) patients, a high level of expression of HER-2/neu receptors was registered in 22 (18%) cases. The mean NPI was 4.99±1.23. We found out that molecular markers corresponding to an excellent prognosis and by the Nottingham prognostic index were assigned to the moderate prognostic group. No statistically significant results was observed between the Nottingham prognostic index and molecular markers that would help in assessing the prognosis (p>0.05). CONCLUSION. In breast cancer, the Nottingham prognostic index is the best tool for prognosis determination than immunohistochemical markers.

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G. et al. Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer // Br J Cancer 2014;110(7):1688–97.Rakha E. A., Soria D., Green A. R., Lemetre C., Powe D. G. et al. Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer // Br J Cancer 2014;110(7):1688–97.Kari D., Jill S. What are the different types of breast cancers // Breast and ovarian cancer. 2011.Kari D., Jill S. What are the different types of breast cancers // Breast and ovarian cancer. 2011.Thompson F., Emerson J., Dalton W., Yang J. M., McGee D., et al. Clonal chromosome abnormalities in human breast carcinomas. I. Twenty-eight cases with primary disease // Genes, Chromosomes, Cancer.1993;7(4):185–93.Thompson F., Emerson J., Dalton W., Yang J. M., McGee D., et al. Clonal chromosome abnormalities in human breast carcinomas. I. Twenty-eight cases with primary disease // Genes, Chromosomes, Cancer.1993;7(4):185–93.Azizun-Nisa, Bhurgri Y., Raza F., Kayani N. Comparison of ER, PR and HER-2/neu (C-erb B 2) reactivity pattern with histologic grade, tumor size and lymph node status in breast cancer // Asian Pac J Cancer Prev. 2008;9(4):553–6. PMID: 19256737.Azizun-Nisa, Bhurgri Y., Raza F., Kayani N. Comparison of ER, PR and HER-2/neu (C-erb B 2) reactivity pattern with histologic grade, tumor size and lymph node status in breast cancer // Asian Pac J Cancer Prev. 2008;9(4):553–6. PMID: 19256737.Moradi-Marjaneh M., Homaei-Shandiz F., Shamsian S. A. A., Eftekhar-Zadeh Mashhadi I., Hedayati-Moghadam M. R. Correlation of HER2/neu over expression, p53 protein accumulation and steroid receptor status with tumor characteristics: an iranian study of breast cancer patients // Iranian J Publ Health. 2008;37(3):19–28.Moradi-Marjaneh M., Homaei-Shandiz F., Shamsian S. A. A., Eftekhar-Zadeh Mashhadi I., Hedayati-Moghadam M. R. Correlation of HER2/neu over expression, p53 protein accumulation and steroid receptor status with tumor characteristics: an iranian study of breast cancer patients // Iranian J Publ Health. 2008;37(3):19–28.Rakha E. A., El-Sayed M. E., Lee A. H. S., Elston C. W., Grainge M. J. et al. Prognostic significance of Nottingham histologic grade in invasive breast carcinoma // J Clin Oncol. 2008;26:3153–3158.Rakha E. A., El-Sayed M. E., Lee A. H. S., Elston C. W., Grainge M. J. et al. Prognostic significance of Nottingham histologic grade in invasive breast carcinoma // J Clin Oncol. 2008;26:3153–3158.Dutta V., Chopra G. S., Sahai K., Nema S. K. Hormone receptors, Her-2/ neu and chromosomal aberrations in breast cancer // Med J Armed Forces India. 2008;64(1):11–15.Dutta V., Chopra G. S., Sahai K., Nema S. K. Hormone receptors, Her-2/ neu and chromosomal aberrations in breast cancer // Med J Armed Forces India. 2008;64(1):11–15.Wu H. H., Alderman M. Hormone receptor assessment of metastatic breast carcinoma by fine needle aspiration utilizing cell blocks and cell transfer techniques: an immunocytochemical review of 163 consecutive cases // J Cytol Tissue Biol. 2016;3:009.Wu H. H., Alderman M. Hormone receptor assessment of metastatic breast carcinoma by fine needle aspiration utilizing cell blocks and cell transfer techniques: an immunocytochemical review of 163 consecutive cases // J Cytol Tissue Biol. 2016;3:009.Briffod M., Hacene K., Le Doussal V. Immunohistochemistry on cell blocks from fine-needle cytopunctures of primary breast carcinomas and lymph node metastases // Modern Pathology. 2000;13(8):841–50.Briffod M., Hacene K., Le Doussal V. Immunohistochemistry on cell blocks from fine-needle cytopunctures of primary breast carcinomas and lymph node metastases // Modern Pathology. 2000;13(8):841–50.Colditz G., Chia K. S. Invasive breast carcinoma: introduction and general features // WHO classification of tumors of the breast / eds by Lakhani S. R., Ellis I. O. Lyon: IARC Press, 2012:14–23.Colditz G., Chia K. S. Invasive breast carcinoma: introduction and general features // WHO classification of tumors of the breast / eds by Lakhani S. R., Ellis I. O. Lyon: IARC Press, 2012:14–23.Shabaik A., Lin G., Peterson M. et al. Reliability of HER2/neu, estrogen receptor and progesterone receptor testing by immunohistochemistry on cell block of FNA and serous effusions from patients with primary and metastatic breast carcinoma // Diagn Cytopathol. 2011;39(5):328–32.Shabaik A., Lin G., Peterson M. et al. Reliability of HER2/neu, estrogen receptor and progesterone receptor testing by immunohistochemistry on cell block of FNA and serous effusions from patients with primary and metastatic breast carcinoma // Diagn Cytopathol. 2011;39(5):328–32.Kurshumliu F., Gashi-Luci L., Kadare S., Alimehmeti M., Gozalan U. Classification of patients with breast cancer according to Nottingham prognostic index highlights significant differences in immunohistochemical marker expression // World journal of surgical oncology. 2014;12(1):1–5.Kurshumliu F., Gashi-Luci L., Kadare S., Alimehmeti M., Gozalan U. Classification of patients with breast cancer according to Nottingham prognostic index highlights significant differences in immunohistochemical marker expression // World journal of surgical oncology. 2014;12(1):1–5.Köseoğlu R. D., Müslehiddinoğlu A., Erkorkmaz Ü., Caferler J. S., Dürer P., Özön Y. H. An analysis of HER-2/neu gene status in invasive ductal carcinomas using immunohistochemistry and fluorescence in situ hybridization // Turkish Journal of Medical Sciences. 2011;41(5):809–19.Köseoğlu R. D., Müslehiddinoğlu A., Erkorkmaz Ü., Caferler J. S., Dürer P., Özön Y. H. An analysis of HER-2/neu gene status in invasive ductal carcinomas using immunohistochemistry and fluorescence in situ hybridization // Turkish Journal of Medical Sciences. 2011;41(5):809–19.Huang H. J., Neven P., Drijkoningen M., Paridaens R., Wildiers H. et al. Association between tumour characteristics and HER-2/neu by immu-nohistochemistry in 1362 women with primary operable breast cancer // J Clin Pathol. 2005;58(6):611–6.Huang H. J., Neven P., Drijkoningen M., Paridaens R., Wildiers H. et al. Association between tumour characteristics and HER-2/neu by immu-nohistochemistry in 1362 women with primary operable breast cancer // J Clin Pathol. 2005;58(6):611–6.Rakha E. A., Soria D., Green A. R., Lemetre C., Powe D. G. et al. Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer // Br J Cancer 2014;110(7):1688–97.Rakha E. A., Soria D., Green A. R., Lemetre C., Powe D. G. et al. Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer // Br J Cancer 2014;110(7):1688–97.

The authors declare that there are no conflicts of interest present.