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Neue prognostische und prädiktive Marker beim Mammakarzinom

New prognostic and predictive markers for breast cancer

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Zusammenfassung

Das Mammakarzinom kann unter Verwendung immunhistochemischer Marker in der klinisch-pathologischen Routinediagnostik in 4 molekulare Subtypen mit unterschiedlicher Prognose eingeteilt werden. Von zentraler Bedeutung ist hierbei, insbesondere zur Unterscheidung von Luminal-A- und Luminal-B-Karzinomen, das Protein Ki-67. Die Bestimmung des Ki-67-Index eines Karzinoms lässt außerdem eine Vorhersage hinsichtlich der Wahrscheinlichkeit des Ansprechens auf eine Chemotherapie zu. Neben Ki-67 sind auch bestimmte Expressionsmuster von Zytokeratinen mit einem geringeren Ansprechen auf eine Chemotherapie assoziiert. Die Heterogenität der histomorphologischen Erscheinung der einzelnen molekularen Subtypen weist auf eine noch größere Diversität des Krankheitsbildes „Brustkrebs“ hin. So konnten wir zeigen, dass ein großer Teil der Luminal-B-Karzinome eine neuroendokrine Differenzierung aufweist. Mit weiteren Studien sollten Mammakarzinome genauer molekular klassifiziert werden, insbesondere unter Zuhilfenahme histomorphologischer Kriterien, um in Zukunft gezieltere Therapien für eine bessere Prognose entwickeln zu können.

Abstract

Breast cancer can be divided into four molecular subtypes with different prognoses using immunohistochemical markers in the routine clinicopathological work-up. The protein Ki-67 is of central importance in this context, in particular to distinguish between luminal A and luminal B carcinomas. Determination of the Ki-67 index of a carcinoma also allows a prediction of the likelihood of the response to chemotherapy. Additionally, the expression of certain cytokeratins in tumor cells is associated with a poor response to chemotherapy. The heterogeneity of molecular subtypes with regard to the histological appearance indicates an even greater diversity of breast cancer. We were able to show that a high proportion of luminal B carcinomas display neuroendocrine differentiation. Further studies with particular emphasis on histomorphological criteria should be performed to attain a more accurate classification of breast cancer and to pave the way towards targeted therapies for a better prognosis in the future.

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  1. Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8–10, 91054, Erlangen, Deutschland

    D. L. Wachter

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D.L. Wachter gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Wachter, D.L. Neue prognostische und prädiktive Marker beim Mammakarzinom. Pathologe 37 (Suppl 2), 217–222 (2016). https://doi.org/10.1007/s00292-016-0210-8

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  • DOI: https://doi.org/10.1007/s00292-016-0210-8

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