Examination of the correlation of expression of HER-2 oncoprotein in the primary tumor with clinical and pathological staging of regional lymph nodes in the axilla in patients with operable breast cancer

Cilj: Određivanje povezanosti statusa humanog epidermalnog faktora rasta (HER-2) onkoproteina, potvrđene metodom hromogene in situ hibridizacije (CISH), sa starosnom dobi, menstrualnim statusom, porodičnom anamnezom, lokalizacijom tumora, kao i kliničkom i patološkom Tumor, Nodus, Metastaza, klasifikacijom tumora (TNM), histopatološkim tipom, histološkim i nuklearnim gradusom, nalazom steroidnih receptora i vrstom sprovedenog hiruškog lečenja, kod primarno operabilnog unicentričnog karcinoma dojke, u određivanju strategije inicijalnog lečenja. Metode: Poređeni su klinički TNM nalazi i opšte karakteristike bolesnica kod kojih je lečenje započeto inicijalnim operativnim zahvatom u periodu 2006-2009. godine, sa definitivnim HP nalazom kojim je određivan tip tumora, veličina, patološki pT i pN, histološki i nuklearni gradus, nalaz steroidnih receptora i CISH amplifikacija. Rezultati: U osnovnoj grupi analizirano je 346 bolesnica sa duktalnim (DC), lobularnim (LC) i drugim tipovima karcinoma dojke. U osnovnoj grupi amplifikacija HER-2 receptora pokazala se kod 72 (20,81%) bolesnica. Za potrebe ovog istraživanja poređene su grupe sa i bez CISH amplifikacije. U odnosu na starosnu dob (p=0.41) i menstrualni status (p=0.54) nije utvrđena statistički značajna razlika. Statistčka značajnost nije dobijena ni u odnosu na lokalizaciju tumora (p=0.65), kao ni prema opštoj i porodočnoj anamnezi vezanoj za maligne bolesti dojke (p=0.77 i p=0.5). U odnosu na HP nalaz, utvrđena je statistički značajna razlika. Sa CISH amplifikacijom je bilo DC - 55 (76,39%), kod LC - 11 (15,28%), ostalo 4 (5,56%), mešoviti karcinomi - 2 (2,78%), p=4.22·10-5 Značajna statistička razlika dobijena je u odnosu na histološki gradus (p=0.015), nuklearni gradus (p=0.00135), kao i na odnos prema steroidnim receptorima (ER p=3⋅10 . Prema kliničkom nodalnom statusu (p=0.78), i patološkom nodalnom statusu (p=0.81), nije utvrđena statistička značajnost. -5, PR p=4⋅10-5)...Purpose: To determine the association of status of human epidermal growth factor (HER- 2) oncoprotein, chromogene confirmed using in situ hybridization (CISH), with age, menstrual status, family history, tumor localization and the clinical and pathological tumor, nodes, metastasis, the classification of tumors (TNM), histopathological type, histological and nuclear grade, steroid receptor findings and type of surgical treatment carried out, the primary operable breast cancer unicentric, in determining initial treatment strategies. Methods: The comparison of the clinical TNM and general characteristics of patients in whom treatment was started with initial surgical procedure in the period of 2006 to 2009, with definite findings that HP was determined by tumor type, size, pathological pT and pN, histologic and nuclear grade, a finding steroid receptors and CISH amplification. Results: The primary group analyzed 346 patients with ductal (DC), lobular (LC) and other brest carcinoma. The amplification of the fundamental group of HER-2 receptor is shown in 72 (20.81%) patients. For the purposes of this study group were compared with and without CISH amplification. In relation to age (p=0.41) and menstrual status (p=0.54) was not statistically significant difference. Statistically significance was not obtained even in relation to the localization of the tumor (p=0.65), as well as the general anamnesis and family anamnesis related to malignant breast disease (p=0.77 and p=0.5). Compared to the HP findings, a statistically significant difference. With CISH amplification was DC - 55 (76.39%), with LC - 11 (15.28%), other - 4 (5.56%), two mixed carcinomas (2.78%) , p=4.22·10-5. According to the clinical nodal status (p=0.78), and pathologic nodal status (p=0.81), not statistically significant. Statistically significant difference was observed in relation to histological grade (p=0.015), nuclear grade (p=0.00135), and the relationship to steroid receptors (ER p=3⋅10-5, PR p=4⋅10-5)..