Nomura Y, Miura S, Koyama H, Enomoto K, Kasumi F, Yamamoto H, Kimura M, Tominaga T, Iino H, Morimoto T
Department of Breast Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Cancer. 1992 Jan 1;69(1):153-64. doi: 10.1002/1097-0142(19920101)69:1<153::aid-cncr2820690127>3.0.co;2-p.
In a retrospective multicenter study to investigate the correlation between estrogen (ER) and/or progesterone receptors (PgR) in primary breast cancer with patient prognosis, 3118 patients with operable breast cancer (International Union Against Cancer Stages I, II, and III) were investigated from ten hospitals in Japan who underwent surgery from October 1972 to December 1982; 3089 were evaluable. The ER-positive and PgR-positive cancers were found in 56% and 34% of patients, respectively. The positivities decreased as the tumor size increased but were independent on lymph node metastasis. There were no significant differences in relapse-free survival (RFS) in relation to receptor status (median follow-up, 89 months [ER], 84 months [PgR]). However, in patients with four or more positive nodes, those with PgR-positive cancer had a longer RFS. The patients with ER-positive cancer survived significantly longer than ER-negative ones, with the greatest difference seen in those with four or more positive nodes. There was a significantly longer postrelapse survival (PRS) for patients with ER-positive cancer because of the different distribution of the major metastasis and better responses to first-line and subsequent treatments. Cox's multivariate analysis showed that overall survival but not PRS was affected by ER (and more weakly by PgR) because of the longer PRS in patients with ER-positive cancer.
在一项回顾性多中心研究中,为了探究原发性乳腺癌中雌激素(ER)和/或孕激素受体(PgR)与患者预后之间的相关性,对1972年10月至1982年12月期间在日本十家医院接受手术的3118例可手术乳腺癌患者(国际抗癌联盟I、II和III期)进行了调查;其中3089例可评估。ER阳性和PgR阳性癌症分别在56%和34%的患者中发现。阳性率随肿瘤大小增加而降低,但与淋巴结转移无关。无复发生存期(RFS)与受体状态无关(中位随访时间,ER为89个月,PgR为84个月)。然而,在有四个或更多阳性淋巴结的患者中,PgR阳性癌症患者的RFS更长。ER阳性癌症患者的生存时间明显长于ER阴性患者,在有四个或更多阳性淋巴结的患者中差异最大。由于主要转移部位的分布不同以及对一线和后续治疗的反应更好,ER阳性癌症患者的复发后生存期(PRS)明显更长。Cox多因素分析显示,总体生存而非PRS受ER影响(受PgR影响较弱),因为ER阳性癌症患者的PRS更长。