Regulatory Mechanisms in Biosystems (Apr 2017)
Immunohistochemical tests for diagnostics of infiltrative forms of breast cancer and identification of molecular subtype in women of different ages in Dnipro city
Abstract
The article presents the results of histological and immunohistochemical testing of women of different ages who are suffering from infiltrative forms of breast cancer in Dnipro. The study presents the distribution of receptors of estrogens and progesterone (ER, PR), HER-2/neu (necessary for prescribing treatment) and Кi-67 (reveals additional features of a tumour). Considering that luminal types of breast cancer include tumours whose receptors express to ER and PR, depending on the kind of expression HER2/neu, they are classified into A (do not express HER2/neu) and B (express HER2/neu). Tumours with hyperexpression of HER2/neu and lack of ER and PR are called HER2+. The research conducted has shown that duct cancer is by far the commonest form, at 81%. In duct cancer, undifferentiated stage and moderately-differentiated stage cancer prevails, whereas with nodule cancer the majority (80%) have moderately-differentiated stage cancer. We discovered a correlative link between the stage of differentiation and the percentage of metastasis both in duct and nodule breast cancer. But nodule breast cancer is more aggressive: with metastasis occurring in 31.2% of women even in cases of moderately-differentiated stage cancer. Only duct cancer is able to produce slime, which distinguishes it from other forms. Combined forms of cancer are rare, but they lead to metastases in all cases. Most women with infiltrative cancer in Dnipro are aged between 51 and 60. There has been observed the increase in cases of breast cancer among young women; the most widespread among infiltrated forms of breast cancer is subtype Luminal A, which has the best prognosis. As the research shows, women under 60 tend to have less aggressive subtypes, which are easy to treat, whereas in older patients their aggressiveness increases substantially, which means an unfavourable prognosis and lower effectiveness of treatment. Кі-67 marker increases substantially in the absence of ER and PR, which means a high level of tumour aggressiveness. Luminal A subtype in not aggressive in most cases, which means the most favourable prognosis. Luminal B is partly aggressive which leads to a high percentage of metastasis, but thanks to ER+ or PR+, it is successfully treated by hormone therapy, which can lead to a positive prognosis. Overall, HER2+ and triple negative are the most aggressive.
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