Tsuda H, Tsugane S, Fukutomi T, Nanasawa T, Yamamoto H, Hirohashi S
Pathology Division, National Cancer Center Research Institute and Hospital, Tokyo.
Jpn J Clin Oncol. 1992 Aug;22(4):244-9.
Post-recurrence survival was examined in 62 breast cancer patients who had undergone curative radical mastectomies between 1974 and 1976 and suffered recurrences within 127 months of surgery. The prognostic value of 11 clinical, histological and genetic factors, including histologic grade of malignancy and amplification of oncogenes was analyzed using univariate and multivariate analyses. Not only the site of first recurrence, clinical stage and size of primary tumor at initial surgery, and disease-free period, but also histologic grade and amplification of the c-erbB-2 proto-oncogene were significant prognostic indicators of recurrent breast cancer. Multivariate analysis using Cox's regression model, histologic grade and amplification of c-erbB-2 in the primary tumor, as well as clinical stage at surgery and site of first recurrence, were shown to be major independent prognostic factors of recurrent breast cancer. Because post-recurrence prognosis was strongly influenced by the clinical, histological and genetic status of the primary breast cancer, appropriate evaluation of the primary tumor for the grade of aggressiveness of the cancer cells, as well as the extent of cancer spread, seem to be important.
对62例在1974年至1976年间接受根治性乳房切除术且在术后127个月内复发的乳腺癌患者进行了复发后生存情况的研究。使用单因素和多因素分析方法，分析了包括恶性组织学分级和癌基因扩增在内的11个临床、组织学和遗传学因素的预后价值。不仅首次复发部位、临床分期、初次手术时原发肿瘤大小和无病生存期，而且组织学分级和c-erbB-2原癌基因的扩增都是复发性乳腺癌的重要预后指标。使用Cox回归模型进行的多因素分析表明，原发肿瘤的组织学分级和c-erbB-2扩增，以及手术时的临床分期和首次复发部位，是复发性乳腺癌的主要独立预后因素。由于复发后的预后受到原发性乳腺癌临床、组织学和遗传学状态的强烈影响，因此对原发性肿瘤进行癌细胞侵袭性分级以及癌症扩散程度的适当评估似乎很重要。
