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. 2022 Oct 24:13:1002173.
doi: 10.3389/fneur.2022.1002173. eCollection 2022.

Conversion of ER, PR, HER2 and Ki-67 and Prognosis in breast cancer metastases to the brain

Chen Jiaxin  1 , Zhou Jinmei  2 , Zhang Huiqiang  2 , Wu Xuexue  2 , Wang Xiaobo  2 , Zhang Shaohua  2 , Tai Yanhong  2 , Jiang Zefei  2 , Wang Tao  1   3   4
Affiliations

Conversion of ER, PR, HER2 and Ki-67 and Prognosis in breast cancer metastases to the brain

Chen Jiaxin et al. Front Neurol. .

Abstract

Objective: This study aimed to analyze the expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index in the brain metastatic lesions and primary lesions in Chinese patients with breast cancer brain metastasis (BCBM) and determine the correlation between their changes and patients' survival.

Methods: A retrospective analysis was performed on patients with BCBM. The clinical characteristic of these patients was collected. The differences in the expression levels of the ER, PR, HER-2, and Ki-67 index between the primary lesions and brain lesions were evaluated, and the association between the differences and survival was analyzed.

Results: The conversion rate of anyone receptor (ER, PR, or HER2) between the primary lesions and brain metastatic lesions was 45.0% (18/40), of which the ER inconsistency rate was 25.0%, the PR inconsistency rate was 22.5%, and the HER-2 inconsistency rate was 15.0%, and the receptor conversion resulted in a subtype conversion of 27.5% (11/40). The patients with HER-2 expression discordance between the primary lesions and the brain metastatic lesions had significantly longer survival times (58.9 vs. 26.4 months, P = 0.04) after diagnosis of brain metastases.

Conclusion: In this study, 45.0% of breast cancer patients developed biomarker-conversion between the primary lesions and brain metastatic lesions, and the differences in the expression levels of the ER, PR, and HER-2, the change in Ki-67 index between the primary lesions and brain lesions may predict patients' survival.

Keywords: ER; HER-2; PR; brain metastases; breast cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Subtype conversion between the brain metastatic lesions and primary lesions in patients with breast cancer.
Figure 2
Figure 2
Survival curves of patients with consistent expression of anyone receptor vs. patients with inconsistent expression of anyone receptor after diagnosis of brain metastases.
Figure 3
Figure 3
Survival curves of patients with consistent HER-2 expression vs. patients with inconsistent HER-2 expression after diagnosis of brain metastases.
Figure 4
Figure 4
Survival curves of patients with positive-to-negative HER-2 expression vs. patients with negative-to-positive HER-2 expression after diagnosis of brain metastases.
Figure 5
Figure 5
Kaplan-Meier curves of the overall survival in patients with consistent HR expression vs. patients with inconsistent HR expression.
Figure 6
Figure 6
Survival curves of patients with consistent HR expression vs. patients with inconsistent HR expression after diagnosis of brain metastases.
Figure 7
Figure 7
Kaplan-Meier curves of the metastasis-free survival in breast cancer patients with brain metastasis whose Ki-67 of ≤ 40% compared to those with Ki-67 of >40% in the primary lesions.
Figure 8
Figure 8
Survival curves of patients whose Ki-67 index difference of >10% vs. patients whose Ki-67 index difference of ≤ 10% after diagnosis of brain metastases.
See this image and copyright information in PMC

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