Castagnetta L, Traina A, Carruba G, Fecarotta E, Palazzotto G, Leake R
Hormone Biochemistry Laboratory, University School of Medicine, Policlinico, Palermo, Italy.
Br J Cancer. 1992 Jul;66(1):167-70. doi: 10.1038/bjc.1992.236.
Nodal involvement is accepted as the best single marker of prognosis in breast cancer. However, there is little information on the sub-division of node-positive patients according to the oestrogen receptor status of the nodal tissue. We have previously reported (Eur. J. Ca. 1987, 23, 31) that, in almost all cases, involved nodes are only oestrogen receptor positive (ER+) in patients whose primary tumours are uniformly ER+. This paper presents clinical follow-up on a larger group of patients with node positive breast cancer. For each patient, both soluble and nuclear receptor concentrations were determined in three separate parts of the primary tumour and in at least one involved node (we have previously defined tumours which contained ER in all six fractions of the primary as HS++, those lacking receptor in some fractions as HS+- and wholly receptor negative tumours as HS--). Median follow-up time was 71.5 months. As expected, patients whose tumours were HS++ had a significant (P less than 0.008) survival advantage. More importantly, patients with ER in both the soluble and nuclear fractions of their involved nodes survived significantly (P less than 0.003) longer than those with ER- nodes. Thus, full oestrogen receptor status of involved nodes will give sufficient prognostic information when adequate primary tissue is not available.
淋巴结受累被认为是乳腺癌预后的最佳单一指标。然而,关于根据淋巴结组织的雌激素受体状态对淋巴结阳性患者进行细分的信息却很少。我们之前报道过(《欧洲癌症杂志》,1987年,第23卷,第31页),在几乎所有病例中,对于原发肿瘤均为雌激素受体阳性(ER+)的患者,受累淋巴结仅为雌激素受体阳性(ER+)。本文展示了对一大组淋巴结阳性乳腺癌患者的临床随访情况。对于每位患者,在原发肿瘤的三个不同部位以及至少一个受累淋巴结中测定了可溶性和核受体浓度(我们之前将原发肿瘤的所有六个部分均含有ER的肿瘤定义为HS++,部分部分缺乏受体的肿瘤定义为HS+-,完全受体阴性的肿瘤定义为HS--)。中位随访时间为71.5个月。正如预期的那样,肿瘤为HS++的患者具有显著的(P小于0.008)生存优势。更重要的是,受累淋巴结的可溶性和核部分均有ER的患者的生存期明显(P小于0.003)长于淋巴结为ER-的患者。因此,当无法获得足够的原发组织时,受累淋巴结的完整雌激素受体状态将提供足够的预后信息。