Baak Jan P A, van Diest Paul J, Voorhorst Feja J, van der Wall Elsken, Beex Louk V A M, Vermorken Jan B, Janssen Emiel A M, Gudlaugsson Einar
Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands, and Department of Pathology, Stavanger University Hospital, P.O. Box 8100, 4068 Stavanger, Norway.
Eur J Cancer. 2007 Feb;43(3):527-35. doi: 10.1016/j.ejca.2006.10.001. Epub 2006 Nov 15.
In lymph-node-negative invasive breast cancer patients<55 years, the proliferation marker mitotic activity index (MAI) has previously been shown to be the strongest prognosticator. In studies without age definition, MAI was not strongly prognostic. We investigated the age dependency of the prognostic value of proliferation for distant metastasis-free (MFS) and overall cancer-related survival (OS) in 1004 histologically diagnosed T1-3N0M0 invasive breast cancers (n=516, <55 years; n=322, 55-70 years; n=166, >70 years) without systemic adjuvant therapy and long follow-up (median: 108 months). The MAI decreases with age and the prognostic value of MAI varied by age group. For patients<55 years, hazard ratios (HR) for MAI>or=10 versus<10 for MFS and OS were 3.1 and 4.4, respectively (P<.0001 for both), but only 1.9 and 1.9 (P=.004 and .006) for patients aged 55-70 years, while over 70 years, MAI was not significant (P=.11). The prognostic value of proliferation was age-dependent. Prognostic breast cancer studies must clearly indicate the age group being studied.
在年龄小于55岁的淋巴结阴性浸润性乳腺癌患者中，增殖标志物有丝分裂活性指数（MAI）此前已被证明是最强的预后指标。在未定义年龄的研究中，MAI的预后价值并不显著。我们调查了1004例经组织学诊断为T1-3N0M0的浸润性乳腺癌患者（n = 516，年龄小于55岁；n = 322，年龄55 - 70岁；n = 166，年龄大于70岁）中，增殖对无远处转移生存期（MFS）和总体癌症相关生存期（OS）的预后价值的年龄依赖性，这些患者未接受全身辅助治疗且随访时间长（中位数：108个月）。MAI随年龄增长而降低，且MAI的预后价值因年龄组而异。对于年龄小于55岁的患者，MAI≥10与＜10相比，MFS和OS的风险比（HR）分别为3.1和4.4（两者P均＜0.0001），但对于年龄55 - 70岁的患者，HR仅为1.9和1.9（P = 0.004和0.006），而对于70岁以上的患者，MAI无显著意义（P = 0.11）。增殖的预后价值具有年龄依赖性。乳腺癌预后研究必须明确指出所研究的年龄组。
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