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首页> 外文期刊>Pathobiology: journal of immunopathology, molecular and cellular biology >Understanding the molecular basis of histologic grade.
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Understanding the molecular basis of histologic grade.

机译：了解组织学等级的分子基础。

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Histologic grading in breast cancer is based on the evaluation of 3 morphologic features (tubule formation, nuclear pleomorphism and mitotic count), is essentially describing proliferation and differentiation in breast cancer, and is considered an important prognostic factor for this disease. It has been suggested that histologic grade 1 and 3 breast tumors are 2 different diseases that may have distinct molecular origins, pathogenesis and natural history. Different single markers like Ki-67, thymidine labeling index and S phase fraction/flow cytometry have been studied as markers of proliferation, but none of them, with the possible exception of Ki-67, is currently employed routinely in clinical practice. The advent of the powerful microarray technology has enabled scientists to comprehensively study proliferation in breast cancer on a genome-wide scale. A gene expression grade index (GGI) was developed that challenges the existence and clinical relevance of an intermediate grade 2 classification. TheGGI could reclassify patients with histologic grade 2 tumors into 2 groups with high versus low risks of recurrence. GGI has also been used to define 2 clinically relevant subgroups in estrogen receptor-positive breast carcinomas. Finally, in the largest meta-analysis of publicly available gene expression and clinical data, 4 stable molecular subgroups of breast cancer have been identified, namely ER-/HER-, HER2+ and ER+/HER2-, which was divided into 2 subgroups (ER+/low proliferation and ER+/high proliferation). In this same meta-analysis, proliferation was shown to be the common driving force responsible for the performance of various breast cancer prognostic signatures.
机译：乳腺癌的组织学分级基于对三种形态学特征（肾小管形成，核多形性和有丝分裂计数）的评估，本质上描述了乳腺癌的增殖和分化，被认为是该疾病的重要预后因素。已经提出组织学1级和3级乳腺肿瘤是2种不同的疾病，可能具有不同的分子起源，发病机理和自然史。已经研究了不同的单一标记物，例如Ki-67，胸苷标记指数和S期分数/流式细胞仪，作为增殖的标记物，但是，除了Ki-67以外，目前都没有在临床实践中常规使用它们。强大的微阵列技术的出现使科学家能够在全基因组范围内全面研究乳腺癌的增殖。提出了一种基因表达等级指数（GGI），该指数挑战中间2级分类的存在和临床意义。 GGI可以将组织学2级肿瘤患者分为高复发风险和低复发风险的2组。 GGI也已用于定义雌激素受体阳性乳腺癌的2个临床相关亚组。最后，在对公开可用的基因表达和临床数据进行的最大荟萃分析中，已鉴定出4个稳定的乳腺癌分子亚组，即ER- / HER-，HER2 +和ER + / HER2-，分为2个亚组（ER + /低增殖和ER + /高增殖）。在同样的荟萃分析中，增殖被证明是导致各种乳腺癌预后特征的共同驱动力。

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