Page D L, Jensen R A, Simpson J F
Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
Breast Cancer Res Treat. 1998;51(3):195-208. doi: 10.1023/a:1006122716137.
Diagnosis coupled with prognostication is the challenge for and charge of the pathologist. In this time of rapidly developing basic knowledge and increasing sophistication in the evaluation of prognostic information, there has also been an important re-evaluation of the validity, reliability, and relevance of classic histopathology. Also, the precision of and criteria for evaluating tumor size and status of regional lymph nodes is under study. Our emphasis in this review is tissue pathology and further, its practical relevance to patient management. Histopathology remains the basis of diagnosis universally; the addition of other elements will increase precision of prediction, particularly of responsiveness to individual therapies. Histologic grade may be integrated to substratify high and low stage cases into prognostically more useful subsets. Histologic types also interact with size and nodal status to predict patients with excellent prognosis. Further refinement of these parameters may occur by analysis within clinical, pathologic, or therapeutic subsets.
诊断与预后判断是病理学家面临的挑战和职责所在。在这个基础知识迅速发展且预后信息评估日益复杂的时代，经典组织病理学的有效性、可靠性及相关性也得到了重要的重新评估。此外，评估肿瘤大小及区域淋巴结状态的精确性和标准也在研究之中。我们在本综述中的重点是组织病理学，以及它与患者管理的实际相关性。组织病理学仍然是普遍诊断的基础；增加其他因素将提高预测的精确性，尤其是对个体治疗反应的预测。组织学分级可用于将高分期和低分期病例进一步分层为预后更具参考价值的亚组。组织学类型也与肿瘤大小和淋巴结状态相互作用，以预测预后良好的患者。通过在临床、病理或治疗亚组内进行分析，这些参数可能会得到进一步完善。
