Joensuu H, Toikkanen S, Klemi P J
Department of Radiotherapy, Turku University Central Hospital, Finland.
Br J Cancer. 1991 Sep;64(3):588-92. doi: 10.1038/bjc.1991.355.
Histology features, the nuclear DNA content and prognosis of 42 female breast carcinomas found in a physical examination based screening, 54 breast cancers found incidentally by medical personnel, and 274 breast cancers first suspected by the patient were compared. There was no significant difference in the distribution by primary tumour size (P = 0.08) or histological type (P = 0.87) of breast cancer between the screen-detected and 139 self-suspected cancers of women with similar mean age and living at the same time in the same city, but the screen-detected carcinomas were better differentiated (P = 0.0002), and had less mitoses (P = 0.008), less tumour necrosis (P = 0.004) and DNA aneuploidy (P = 0.01), smaller S-phase fractions (P = 0.009), less axillary metastases (P = 0.04), and had better outcome (P = 0.005) than self-suspected carcinomas. These parameters did not differ significantly between the screen-detected and incidentally found cancers, but incidental cancers had more often axillary metastases (P = 0.02). The results indicate that screen-detected breast carcinomas have favourable biological features suggesting low degree of malignant potential.
对在基于体检的筛查中发现的42例女性乳腺癌、医务人员偶然发现的54例乳腺癌以及患者最初怀疑的274例乳腺癌的组织学特征、核DNA含量和预后进行了比较。在平均年龄相似且同时居住在同一城市的女性中,筛查发现的乳腺癌与139例自我怀疑的乳腺癌相比,原发性肿瘤大小的分布(P = 0.08)或组织学类型(P = 0.87)无显著差异,但筛查发现的癌分化更好(P = 0.0002),有丝分裂更少(P = 0.008),肿瘤坏死更少(P = 0.004)和DNA非整倍体更少(P = 0.01),S期分数更小(P = 0.009),腋窝转移更少(P = 0.04),并且与自我怀疑的癌相比预后更好(P = 0.005)。这些参数在筛查发现的癌和偶然发现的癌之间无显著差异,但偶然发现的癌腋窝转移更常见(P = 0.02)。结果表明,筛查发现的乳腺癌具有良好的生物学特征,提示恶性潜能程度较低。