Wernicke M
Surg Gynecol Obstet. 1975 Jun;140(6):919-24.
The main quantitative problem in the pathologic evaluation of carcinoma of the breast is how to appraise host resistance. To study this in 107 patients with radically excised carcinoma of the breast, the axillary lymph nodes were weighed, the average sinus histiocytosis was estimated, and the plasma cells in the medullary cords were counted and expressed as a plasma cell index. The product of the lymphoid weight, the average sinus histiocytosis and the plasma cell index multiplied by 0.1 is called the hyperplasia index, which expresses quantitatively the cell mediated immunity and the humoral immunity in the axillary lymph nodes. The hyperplasia index was correlated with the metastatic tumor weight in the primary tumor with blood vessel invasion, lymphoid infiltration and volume of the tumor. There was a significant inverse relationship, p smaller than 0.001, between the hyperplasia index and the ratio of metastatic tumor weight to lymphoid weight. A significant direct relationship was found in the women with blood vessel invasion and low hyperplasia index values with increased metastatic tumor weight ratio to lymphoid weight, p smaller than 0.01. In patients without metastatic lymph nodes, there was a direct relationship between high hyperplasia indexes and lymphoid infiltration of the frank tumor, p smaller than 0.05. The hyperplasia index is considered a quantitative morphologic evaluation of the regional host defense reaction in the axillary lymph nodes, reflecting the antigenic strength of the tumor and the immune response to it.
乳腺癌病理评估中的主要定量问题是如何评估宿主抵抗力。为了对107例接受乳腺癌根治术的患者进行研究，对腋窝淋巴结进行称重，估算平均窦组织细胞增生情况，并对髓索中的浆细胞进行计数并以浆细胞指数表示。淋巴组织重量、平均窦组织细胞增生情况与浆细胞指数三者的乘积乘以0.1称为增生指数，它定量表达了腋窝淋巴结中的细胞介导免疫和体液免疫。增生指数与伴有血管侵犯、淋巴样浸润及肿瘤体积的原发肿瘤中的转移瘤重量相关。增生指数与转移瘤重量与淋巴组织重量之比之间存在显著的负相关关系，p值小于0.001。在有血管侵犯且增生指数值低的女性中，发现转移瘤重量与淋巴组织重量之比增加，二者呈显著正相关关系，p值小于0.01。在无转移淋巴结的患者中，高增生指数与原发肿瘤的淋巴样浸润之间存在正相关关系，p值小于0.05。增生指数被认为是对腋窝淋巴结局部宿主防御反应的定量形态学评估，反映了肿瘤的抗原强度及其免疫反应。
