Görlich M, Jandrig B
Max Delbrück Center of Molecular Medicine, Berlin, FRG.
Neoplasma. 1999;46(2):112-6.
Estradiol receptors are regarded to predict a likely success of hormonal therapeutic efforts and the prognosis of breast cancer patients. But today its prognostic importance is controversial, discussed as either reflecting intrinsic property of the tumor tissue or better therapeutic accessibility of receptor positive tumors. Moreover, the most important clinical prognosticators--tumor size and axillary lymph node involvement do not seem to be related to the estradiol receptor status. In our investigation, the length of disease free interval is similar in estradiol receptor positive and negative patients and in all sites of distant metastases, but it is significantly reduced if more than 4 axillary lymph nodes are involved. Post recurrence survival is significantly longer in estradiol receptor positive than negative patients and also in patients treated by tamoxifen containing therapies. Its length is independent of the number of axillary lymph node metastases and the type of distant metastases, with a tendency to be longer in estradiol receptor positive than negative patients. In addition, the overall survival is longer for estradiol receptor positive than negative patients and becomes reduced with more than 4 axillary lymph node metastases. Frequency of deaths in estradiol receptor positive patients is half that of negative subjects. Furthermore, the length of overall survival is independent on the type of distant metastases, with tendency to be longer in estradiol receptor positive than negative patients. Longest overall survival could be observed for estradiol receptor positive patients who got therapy regimens containing tamoxifen. The weak prognostic advantages of estradiol receptor positive patients are interpreted by estradiol receptors as intrinsic parameters of breast cancer tissue characterizing more its biological behavior than therapeutic accessibility.
雌二醇受体被认为可预测激素治疗效果及乳腺癌患者的预后。但如今其预后重要性存在争议，有人认为它反映肿瘤组织的内在特性，也有人认为它体现受体阳性肿瘤更好的治疗可及性。此外，最重要的临床预后指标——肿瘤大小和腋窝淋巴结受累情况似乎与雌二醇受体状态无关。在我们的研究中，无病生存期在雌二醇受体阳性和阴性患者以及所有远处转移部位中相似，但如果腋窝淋巴结受累超过4个，无病生存期会显著缩短。复发后生存期在雌二醇受体阳性患者中明显长于阴性患者，在接受含他莫昔芬治疗的患者中也是如此。其长度与腋窝淋巴结转移数量及远处转移类型无关，雌二醇受体阳性患者的生存期往往长于阴性患者。此外，雌二醇受体阳性患者的总生存期长于阴性患者，且随着腋窝淋巴结转移超过4个而缩短。雌二醇受体阳性患者的死亡频率是阴性患者的一半。此外，总生存期的长度与远处转移类型无关，雌二醇受体阳性患者的总生存期往往长于阴性患者。接受含他莫昔芬治疗方案的雌二醇受体阳性患者的总生存期最长。雌二醇受体阳性患者微弱的预后优势被解释为，雌二醇受体作为乳腺癌组织的内在参数，更多地表征其生物学行为而非治疗可及性。
