Thor A D, Liu S, Moore D H, Edgerton S M
Department of Pathology and Evanston Northwestern Healthcare Research Institute, Evanston Hospital, IL, USA.
J Clin Oncol. 1999 Feb;17(2):470-7. doi: 10.1200/JCO.1999.17.2.470.
To investigate the hypothesis that in vitro bromodeoxyuridine (BrDu) labeling might be superior to MIB-1 immunostaining for prognostic value, because it more selectively labels cells during the S phase.
Four hundred eighty-six patients with breast cancers (59% lymph node-negative, 41% lymph node-positive) surgically excised between 1988 and 1993 (median follow-up, 62 months) were evaluated for cellular proliferation using prospective in vitro BrDu uptake assays, retrospective mitotic indices, and MIB-1 labeling.
MIB-1, BrDu labeling, and mitotic index-derived proliferation data were highly correlated. Each was similarly associated with most other markers of prognosis, although these relationships were not identical. By univariate analysis, nodal status was the most significant prognostic variable for all patients. Higher BrDu labeling index, MIB-1 immunolabeling, and mitotic index were also associated with shortened disease-free survival (DFS) and disease-specific survival for the entire patient group, as well as for node-negative patients. The association between cellular proliferation and survival was much weaker for node-positive patients. Multivariate models confirmed that nodal status, tumor size, and proliferation data predicted survival in all patients as well as those with node-negative disease, although MIB-1 was somewhat more closely associated with outcome than mitotic index or in vitro BrDu data. For patients with T1NOMO disease (n = 172), the only significant predictors of DFS were proliferation rate (mitotic index or MIB-1) and tumor grade.
Proliferation rate predicts recurrence and survival in breast cancer. This effect is more pronounced in node-negative patients. In vitro BrDu data are not superior to MIB-1 and mitotic counting.
探讨体外溴脱氧尿苷（BrDu）标记在预后价值方面可能优于MIB-1免疫染色的假说，因为它在S期更具选择性地标记细胞。
对1988年至1993年手术切除的486例乳腺癌患者（59%淋巴结阴性，41%淋巴结阳性，中位随访时间62个月），使用前瞻性体外BrDu摄取试验、回顾性有丝分裂指数和MIB-1标记评估细胞增殖情况。
MIB-1、BrDu标记和有丝分裂指数衍生的增殖数据高度相关。尽管这些关系并不完全相同，但每一项都与大多数其他预后标志物相似相关。单因素分析显示，淋巴结状态是所有患者中最显著的预后变量。较高的BrDu标记指数、MIB-1免疫标记和有丝分裂指数也与整个患者组以及淋巴结阴性患者的无病生存期（DFS）缩短和疾病特异性生存期缩短相关。细胞增殖与生存之间的关联在淋巴结阳性患者中要弱得多。多变量模型证实，淋巴结状态、肿瘤大小和增殖数据可预测所有患者以及淋巴结阴性疾病患者的生存情况，尽管MIB-1与预后的关联比有丝分裂指数或体外BrDu数据更为密切。对于T1N0M0疾病患者（n = 172），DFS的唯一显著预测因素是增殖率（有丝分裂指数或MIB-1）和肿瘤分级。
增殖率可预测乳腺癌的复发和生存情况。这种效应在淋巴结阴性患者中更为明显。体外BrDu数据并不优于MIB-1和有丝分裂计数。
