Changes in expression of immunohistochemical markers in regional breast cancer metastases

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OBJECTIVE

To assess the incidence of discordant status of estrogen receptors (REs), progesterone receptors (RPs), Her2/neu and Ki-67 cells of primary tumors and regional metastases in breast cancer (BC), as well as to identify patterns in the expression of these markers during metastasis.

MATERIAL AND METHODS

The material of the primary tumor and regional metastases from 104 patients with a diagnosis of invasive breast cancer of a non-specific type was studied by the immunohistochemical (IHC) method with monoclonal antibodies to RE, RP, Her2/neu and Ki-67, as well as by SISH method. The frequency of cases was compared with a change in status, increase and decrease in the expression level of each biomarker during metastasis, as well as the expression level of biomarkers in the primary tumor and metastases.

RESULTS

A change in the status and expression level during regional metastasis of breast cancer was revealed: RE in 10 (9.6%) and 67 (64.4%), RP in 17 (16.3%) and 64 (61.5%), Her2/neu in 9 (8.6%) and 52 (50.0%), Ki-67 in 37 (35.6%) and 47 (45.2%) cases out of 104, respectively. In groups with a moderate level of expression of RE and RP in the cells of the primary tumor, an increase in the expression level of each type of hormonal receptors was found, as well as a correlation of such changes (correlation coefficient 0.67). A significant decrease in the level of Her2/neu expression in metastatic tissue was revealed in the case of uncertain (2+) level of Her2/neu expression in cells of the primary tumor, which is accompanied by the preservation of Her2/neu status of tumor (84.2% of cases) and an increase in the level of expression of RE.

CONCLUSION

The study demonstrated that for some patients with locally advanced breast cancer, IHC studies of only primary tumor cells are insufficient, because due to the existing discordance of status of RE, RP, Her2/neu and Ki-67 in the tissue of regional metastases in such cases, another therapeutic approach is needed. The patterns and relationships of changes in the level of expression of these biomarkers during regional metastasis of breast cancer were revealed, expanding the understanding of tumor biology.

Keywords:

breast cancer

metastases

tumor heterogeneity

estrogen receptors

progesterone receptors

Her2/neu

Ki-67

Authors:

Konyshev K.V.

Institute of Medical Cell Technologies;
Ural State Medical University

Sazonov S.V.

Institute of Medical Cell Technologies;
Ural State Medical University

Received:

20.12.2019

Accepted:

20.04.2020

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