Lipponen P K, Collan Y, Eskelinen M J
Department of Pathology, University of Kuopio, Finland.
Int Surg. 1991 Oct-Dec;76(4):245-9.
A prospective study on breast cancer was started in 1975, and ended in 1987 allowing a mean follow-up of 12.4 years. At the operation tumor size was registered, and after axillary evacuation axillary status was defined histologically. In 1989-1990 volume corrected mitotic index (M/V index), and mitotic activity index (MAI) were estimated, and histological grading performed from archival paraffin sections. In univariate survival analysis axillary node status (p less than 0.0001), M/V index (p less than 0.0001), MAI (p = 0.0001), and tumor size (p = 0.0009), histological grade (p = 0.0195), and irregularity of nuclei (p = 0.0167) predicted survival, recurrence free survival, and breast cancer survival. In a multivariate survival analysis axillary node status, M/V index, tumor size and tubular growth pattern showed independent prognostic value in the order of significance. In the separate analysis of infiltrative ductal or lobular carcinomas the M/V index was the most important prognosticator. The results suggest that the M/V index is more powerful in predicting survival than the mitotic activity index (MAI) in breast cancer. Obviously this is due to better control of variation factors associated with field size and area of epithelium by the M/V index.
一项关于乳腺癌的前瞻性研究始于1975年，于1987年结束，平均随访时间为12.4年。手术时记录肿瘤大小，腋窝清扫后通过组织学确定腋窝状态。1989 - 1990年，估算体积校正有丝分裂指数（M/V指数）和有丝分裂活性指数（MAI），并从存档石蜡切片进行组织学分级。在单因素生存分析中，腋窝淋巴结状态（p < 0.0001）、M/V指数（p < 0.0001）、MAI（p = 0.0001）、肿瘤大小（p = 0.0009）、组织学分级（p = 0.0195）和细胞核不规则性（p = 0.0167）可预测生存、无复发生存和乳腺癌生存。在多因素生存分析中，腋窝淋巴结状态、M/V指数、肿瘤大小和管状生长模式按显著性顺序显示出独立的预后价值。在浸润性导管癌或小叶癌的单独分析中，M/V指数是最重要的预后指标。结果表明，在预测乳腺癌生存方面，M/V指数比有丝分裂活性指数（MAI）更具效力。显然，这是由于M/V指数能更好地控制与视野大小和上皮面积相关的变异因素。
