Takayuki Iwamoto    Department   Kawasaki Medical School  Kawasaki Medical School, Department of Breast and Thyroid Surgery,    Position   Assistant Professor
Article types	原著
Language	English
Peer review	Peer reviewed
Title	Molecular anatomy of breast cancer stroma and its prognostic value in estrogen receptor-positive and -negative cancers.
Journal	Formal name：Journal of clinical oncology : official journal of the American Society of Clinical Oncology Abbreviation：J Clin Oncol ISSN code：15277755/0732183X
Domestic / Foregin	Foregin
Volume, Issue, Page	28(28),pp.4316-23
Author and coauthor	Giampaolo Bianchini, Yuan Qi, Ricardo H Alvarez, Takayuki Iwamoto, Charles Coutant, Nuhad K Ibrahim, Vicente Valero, Massimo Cristofanilli, Marjorie C Green, Laszlo Radvanyi, Christos Hatzis, Gabriel N Hortobagyi, Fabrice Andre, Luca Gianni, W Fraser Symmans, Lajos Pusztai
Publication date	2010/10
Summary	PURPOSE:The purpose of this study was to identify genes enriched in breast cancer stroma, assess the stromal gene expression differences between estrogen receptor (ER) -positive and -negative cancers, and separately determine their prognostic value in these two subtypes of breast cancers.METHODS:We compared gene expression profiles of pairs of fine-needle (stroma-poor) and core-needle (stroma-rich) biopsies from 37 cancers to identify stroma-associated genes. We defined stromal metagenes and tested their prognostic values in 684 node-negative patients who received no systemic adjuvant therapy and 259 tamoxifen-treated patients.RESULTS:We identified 293 probe sets overexpressed in core biopsies; these included five highly coexpressed gene clusters (metagenes) corresponding to immune functions and extracellular matrix components. These genes showed quantitative and qualitative differences between ER-positive and ER-negative cancers. A B-cell/plasma cell metagene showed strong prognostic value in ER-positive highly proliferative cancers, a lesser prognostic value in ER-negative cancers, and no prognostic value in ER-positive cancers with low proliferation. The hazard ratio for distant relapse in the lowest compared with the highest tertile of the pooled prognostic data set was 4.29 (95% CI, 2.04 to 9.01; P = .001) in ER-positive cancers and 3.34 (95% CI, 1.60 to 6.97; P = .001) in ER-negative cancers. This remained significant in multivariate analysis including routine variables and other genomic prognostic scores. As a result of quantitative differences in this metagene between ER-positive and ER-negative cancers, different thresholds apply in the two subgroups. Other stromal metagenes had inconsistent prognostic value.CONCLUSION:Among ER-negative and ER-positive highly proliferative cancers, a subset of tumors with high expression of a B-cell/plasma cell metagene carries a favorable prognosis.
DOI	10.1200/JCO.2009.27.2419
PMID	20805453