Cập nhật hướng dẫn về việc kiểm tra thụ thể Estrogen và Progesterone trong ung thư vú: Cập nhật từ Hiệp hội Ung thư Lâm sàng Hoa Kỳ/Trường Cao đẳng Bác sĩ Pat thuộc Mỹ
Tóm tắt
Cập nhật các khuyến nghị chính của Hiệp hội Ung thư Lâm sàng Hoa Kỳ/Trường Cao đẳng Bác sĩ Pat thuộc Mỹ về việc kiểm tra thụ thể estrogen (ER) và thụ thể progesterone (PgR) trong hướng dẫn ung thư vú.
Một ban chuyên gia quốc tế đa ngành đã được triệu tập để cập nhật các khuyến nghị trong hướng dẫn thực hành lâm sàng dựa trên một đánh giá hệ thống về tài liệu y khoa.
Ban chuyên gia tiếp tục khuyến nghị việc kiểm tra ER của các khối u vú xâm lấn qua phương pháp hóa mô miễn dịch đã được xác thực như là tiêu chuẩn để dự đoán bệnh nhân nào có thể hưởng lợi từ liệu pháp nội tiết, và không khuyến nghị bất kỳ xét nghiệm nào khác cho mục đích này. Các mẫu ung thư vú với từ 1% đến 100% nhân tế bào khối u dương tính được hiểu là dương tính với ER. Tuy nhiên, ban chuyên gia thừa nhận rằng có rất ít dữ liệu về lợi ích liệu pháp nội tiết cho các khối u với từ 1% đến 10% tế bào nhuộm dương tính với ER. Các mẫu có kết quả này nên được báo cáo bằng một danh mục báo cáo mới, ER Dương Tính Thấp, kèm theo một nhận xét khuyến nghị. Một mẫu được coi là âm tính với ER nếu < 1% hoặc 0% nhân tế bào khối u có phản ứng miễn dịch. Các chiến lược bổ sung được khuyến nghị để thúc đẩy hiệu suất, diễn giải và báo cáo tối ưu cho các trường hợp với kết quả nhuộm ER ban đầu thấp tới không bao gồm việc thiết lập quy trình hoạt động tiêu chuẩn cụ thể cho từng phòng thí nghiệm mô tả các bước bổ sung được sử dụng bởi phòng thí nghiệm để xác nhận/quyết định kết quả. Tình trạng của các đối chứng nên được báo cáo cho các trường hợp có từ 0% đến 10% nhuộm. Các nguyên tắc tương tự áp dụng cho việc kiểm tra PgR, chủ yếu được sử dụng cho mục đích dự đoán trong trường hợp ung thư dương tính với ER. Việc kiểm tra ung thư biểu mô ống dẫn (DCIS) đối với ER được khuyến nghị để xác định lợi ích tiềm năng của liệu pháp nội tiết nhằm giảm nguy cơ ung thư vú trong tương lai, trong khi kiểm tra DCIS đối với PgR được coi là tùy chọn. Thông tin bổ sung có thể được tìm thấy tại www.asco.org/breast-cancer-guidelines.
Từ khóa
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