Detección del receptor tipo 2 del factor de crecimiento epidérmico humano (her2/neu)

Autores/as

  • José Luis Quirós Alpízar Universidad de Costa Rica
  • Isabel Arce Jiménez Universidad de Costa Rica
  • Gabriel Torrealba Acosta Universidad de Costa Rica
  • Ernesto Jiménez Montero Universidad de Costa Rica
  • Raquel Barrientos Cordero Universidad de Costa Rica

DOI:

https://doi.org/10.51481/amc.v57i1.866

Palabras clave:

cáncer de mama, receptor tipo 2 del factor de crecimiento epidérmico humano (HER-2), inmunohistoquímica

Resumen

Antecedentes: la incidencia y mortalidad por cáncer de mama han presentado un aumento neto. Uno de los tipos de esta heterogénea enfermedad se caracteriza por la amplificación y alta expresión del gen ERBB2, que codifica el receptor tipo 2 del factor de crecimiento epidérmico humano (HER2). Este receptor estimula procesos oncogénicos y dichos tumores se asocian a un peor pronóstico. El objetivo del estudio fue analizar las características de tumores HER-2+ en un grupo de pacientes con carcinoma de mama.

Métodos: se estudió los casos de mujeres con biopsia diagnóstica de cáncer de mama registrados durante 2006 en los archivos del Servicio de Anatomía Patológica del Hospital San Juan de Dios; entre los que contaban con estudios inmunohistoquímicos, se estudió la expresión de HER-2 y se realizó análisis estadísticos.

Resultados: se halló 34 tumores HER-2+ (15,7%), 24 con expresión fuerte (11,1%) y 10 con débil (4,6%). La edad media al diagnóstico de las pacientes con expresión fuerte fue de 46,9 años (42,5-51,1 IC 95%), y con expresión débil fue de 54,4 años (46,7-62,1 IC 95%); la edad promedio para los tumores HER-2- fue de 58,1 años (56,2-60,0 IC 95%). Las pacientes <50 años tuvieron un OR=3,477 de tener HER-2+. De 21 tumores, el 90,5% presentó un grado histológico alto, y de 16 casos, únicamente 3 tenían un tamaño <2 cm.

Conclusión: se encontró una asociación del tipo HER-2+ con pacientes jóvenes, tumores de mayor tamaño y alto grado histológico. Los datos encontrados en este primer reporte son similares a las últimas estimaciones mundiales.

Citas

De Kruif P. Los cazadores de microbios. 7ma ed. México: Editorial Época; 1978.

Perou C, Sorlie T, Eisen M, van de Rijn M, Jeffrey S, Rees C, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747-52.

Dahabreh I, Linardou H, Siannis F, Fountzilas G, Murray S. Trastuzumab in the adjuvant treatment of early-stage breast cancer: a systematic review and metaanalysis of randomized controlled trials. Oncologist. 2008;13:620-30.

Joerger A, Fersht A. Structure-function-rescue: the diverse nature of common p53 cancer mutants. Oncogene. 2007;26:2226-42.

Mukohara T. Role of HER2-targeted agents in adjuvant treatment for breast cancer. Chemother Res Pract. 2011;2011:730360.

Moasser M. The oncogene HER2: its signaling and transforming functions and its role in human cancer pathogenesis. Oncogene. 2007;26:6469-87.

Sorlie T, Perou C, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 2001;98:10869-74.

Ménard S, Fortis S, Castiglioni F, Agresti R, Balsari A. HER2 as a prognostic factor in breast cancer. Oncology. 2001;61:67-72.

Cheang M, Chia S, Voduc D, Gao D, Leung S, Snider J, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst. 2009;101:736-50.

Morrow P, Hortobagyi G. Management of breast cancer in the genome era. Annu Rev Med. 2009;60:153-65.

Pfeifer G, Besaratinia A. Mutational spectra of human cancer. Hum Genet. 2009;125:493-506.

Burstein H. The distinctive nature of HER2-positive breast cancers. N Engl J Med. 2005;353:1652-4.

Nathanson K, Domchek S. Therapeutic approaches for women predisposed to breast cancer. Annu Rev Med. 2011;62:295-306.

Rouzier R, Perou C, Symmans W, Ibrahim N, Cristofanilli M, Anderson K, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 2005;11:5678-85.

Vargas R, Ortiz A, Muñoz G. Incidencia y mortalidad del cáncer Costa Rica 1995-2005. Ministerio de Salud. 2007;17-29.

Wolff A, Hammond M, Schwartz J, Hagerty K, Allred D, Cote R, et al. American Society of Clinical Oncology. College of american pathologist guideline recommendatios for human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2007;131:18-43.

Slamon D, Clark G, Wong S, Levin W, Ullrich A, McGuire W. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177-82.

Slamon D, Godolphin W, Jones L, Holt J, Wong S, Keith D, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science. 1989;244:707-12.

Hudis C. Trastuzumab-mechanism of action and use in clinical practice. N Engl J Med. 2007;357:39-51.

Al Tamimi D, Shawarby M, Ahmed A, Hassan A, AlOdaini A. Protein expression profile and prevalence pattern of the molecular classes of breast cancer-a Saudi population based study. BMC Cancer. 2010;10:223.

Kwan M, Kushi L, Weltzien E, Maring B, Kutner S, Fulton R, et al. Epidemiology of breast cancer subtypes in two prospective cohort studies of breast cancer survivors. Breast Cancer Res. 2009;11:R31.

Parise C, Bauer K, Caggiano V. Variation in breast cancer subtypes with age and race/ethnicity. Crit Rev Oncol Hematol. 2010;76:44-52.

Parise C, Bauer K, Brown M, Caggiano V. Breast cancer subtypes as defined by the estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) among women with invasive breast cancer in California, 1999-2004. Breast J. 2009;15:593-602.

International drug monitoring: the role of national centres. World Health OrganTech Rep Ser. 1972;498:1-25.

Spitale A, Mazzola P, Soldini D, Mazzucchelli L, Bordoni A. Breast cancer classification according to immunohistochemical markers: clinicopathologicre features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol. 2009;20:628-35.

Irigoyen M, Garcia F, Iturriagagoitia A, Beroiz B, Martinez M, Grima F. Molecular subtypes of breast cancer: prognostic implications and clinical and immunohistochemical characteristics. An Sist Sanit Navar. 2011;34:219-33.

Caldarella A, Crocetti E, Bianchi S, Vezzosi V, Urso C, Biancalani M, et al. Female breast cancer status according to ER, PR and HER2 expression: a population based analysis. Pathol Oncol Res. 2011;17:753-8.

Del Casar J, Martín A, García C, CorteM, Alvarez A, Junquera S, et al. Characterization of breast cancer subtypes by quantitative assessment of biological parameters: relationship with clinicopathological characteristics, biological features and prognosis. Eur J Obstet Gynecol Reprod Biol. 2008;141:147-52.

Muñoz M, Fernández-Aceñero M, Martín S, Schneider J. Prognostic significance of molecular classification of breast invasive ductal carcinoma. Arch Gynecol Obstet. 2009;280:43-8.

Sanpaolo P, Barbieri V, Genovesi D. Prognostic value of breast cancer subtypes on breast cancer specific survival, distant metastases and local relapse rates in conservatively managed early stage breast cancer: a retrospective clinical study. Eur J Surg Oncol. 2011;37:876-82.

Kennecke H, Yerushalmi R, Woods R, Cheang M, Voduc D, Speers C, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010;28:3271-7.

Voduc K, Cheang M, Tyldesley S, Gelmon K, Nielsen T, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol. 2010;28:1684-91.

Vallejos C, Gómez H, Cruz W, Pinto J, Dyer R, Velarde R, et al. Breast cancer classification according to immunohistochemistry markers: subtypes and association with clinicopathologic variables in a peruvian hospital database. Clin Breat Cancer. 2010;10:294-300.

Telli M, Chang E, Kurian A, Keegan T, McClure L, Lichteszatajn D, et al. Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry. Breast Cancer Res Treat. 2011;127:471-8.

Lin C, Liau J, Lu Y, Huan C, Lee W, Kuo K, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev 2009;18:1807-14.

Zhang H, Zhang B, Xuan L, Zhao P. Clinical characteristics and survival in the operable breast cancer patients with different molecular subtypes. Zhonghua zhong liu za zhi. 2009;31:447-51.

Zhang Q, Tang S, Liu H. Early stage triple negative and HER2 overexpression breast cancers have similar survivals in Chinese patients. Breast J 2012;18:286-8.

Zhao J, Liu H, Wang M, Gu L, Guo X, Gu F, et al. Characteristics and prognosis for molecular breast cancer subtypes in Chinese women. J Surg Oncol 2009;100:89-94.

Chen X, Ma C, Wu J, Yang W, Lu H, Wu J, et al. Molecular subtype approximated by quantitative estrogen receptor, progesterone receptor and Her2 can predict the prognosis of breast cancer. Tumori. 2010.

Su Y, Zheng Y, Zheng W, Gu K, Chen Z, Li G, et al. Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study. BMC Cancer. 2011;11:292.

Tamimi R, Baer H, Marotti J, Galan M, Galaburda L, Fu Y, et al. Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer. Breast Cancer Res. 2008;10:R67.

Huo D, Ikpatt F, Khramtsov A, Dangou J, Nanda R, Dignam J, et al. Population differences in breast cancer: survey in indigenous African women reveals overrepresentation of triple-negative breast cancer. J Clin Oncol. 2009;27:4515-21.

Abdelkrim S, Trabelsi A, Missaoui N, Barizig N, Bdioui A, Anjorin A, et al. Distribution of molecular breast cancer subtypes among Tunisian women and correlation with histopathological parameters: A study of 194 patients. Pathol Res Pract. 2010;206:772-5.

Adebamowo C, Famooto A, Ogundiran T, Aniagwu T, Nkwodimmah C, Akang E. Immunohistochemical and molecular subtypes of breast cancer in Nigeria. Breast Cancer Res Treat. 2008;110:183-8.

Park S, Koo J, Kim M, Park H, Lee J, Lee J, et al. Characteristics and outcomes according to molecular subtypes of breast cancer as classified by a panel of four biomarkers using immunohistochemistry. Breast. 2012;21:50-7.

Wang Y, Yin Q, Yu Q, Zhang J, Liu Z, Wang S, et al. A retrospective study of breast cancer subtypes: the risk of relapse and the relations with treatments. Breast Cancer Res Treat. 2011;130:489-98.

Carey L, Perou C, Livasy C. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006;295:2492-502.

Keegan T, DeRouen M, Press D, Kurian A, Clarke C. Occurrence of breast cancer subtypes in adolescent and young adult women. Breast Cancer Res. 2012;14:R55.

Ihemelandu C, Leffall L, Dewitty R, Naab T, Mezghebe H, Makambi K, et al. Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival. J Surg Res. 2007;143:109-18.

Onitilo A, Engel J, Greenlee R, Mukesh B. Breast cancer subtypes based on ER/ PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res. 2009;7:4-13.

Bhargava R, Striebel J, Beriwal S. Prevalence, morphologic features and proliferation indices of breast carcinoma molecular classes using immunohistochemical surrogate markers. Int J Clin Exp Pathol. 2009;2:44455.

Wiechmann L, Sampson M, Stempel M, Jacks L, Patil S, King T, et al. Presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol. 2009;16:2705-10.

Runnak M, Hazha M, Hemin H, Wasan A, Rekawt R, Michael H. A populationbased study of Kurdish breast cancer in northern Iraq: hormone receptor and HER2 status. A comparison with Arabic women and United States SEER data. BMC Womens Health. 2012;12:16.

Blows F, Driver K, Schmidt M, Broeks A, van Leeuween F, Wesseling J, et al. Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS medicine. 2010;7.

Descargas

Publicado

2015-01-30 — Actualizado el 2015-01-30

Versiones

Cómo citar

Alpízar, J. L. Q., Jiménez, I. A., Acosta, G. T., Montero, E. J., & Cordero, R. B. (2015). Detección del receptor tipo 2 del factor de crecimiento epidérmico humano (her2/neu). Acta Médica Costarricense, 57(1), 23–28. https://doi.org/10.51481/amc.v57i1.866