Michaelson James S, Chen L Leon, Silverstein Melvin J, Mihm Martin C, Sober Arthur J, Tanabe Kenneth K, Smith Barbara L, Younger Jerry
Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Cancer. 2009 Nov 1;115(21):5095-107. doi: 10.1002/cncr.24592.
: It has long been appreciated that tumor size, lymph node status, and patient survival are related qualities, although how to isolate their interactions has not been obvious, nor has it been obvious how to integrate tumor size and lymph node status into predictions of the risk of death for individual patients.
: The authors describe a mathematical method, the binary-biological model of cancer metastasis, based on the spread of cancer cells, in which the equations capture the relations between tumor size, lymph node status, and cancer lethality.
: For melanoma, renal cell carcinoma, and breast carcinoma, the relation between tumor size and the risk of cancer death was captured by the SizeOnly equation. For melanoma and breast carcinoma, the relation between tumor size and the presence of cancer in the lymph nodes was captured by using the NodalSizeOnly equation. For lymph node-negative melanoma and breast carcinoma, the relation between tumor size and risk of death was captured by the PrimarySizeOnly equation. For breast carcinoma, the model indicated that each positive lymph node contributed approximately 6% extra risk of death, whereas each millimeter of greatest primary tumor dimension contributed approximately 1% risk of death. For melanoma, each positive lymph node contributed approximately 23% risk of death, whereas each millimeter of primary melanoma thickness contributed approximately 8% risk of death. This information was captured by a pair of linked equations, the Size+Nodes method.
: Both tumor size and the number of positive lymph nodes made independent contributions to the risk of cancer death, as estimated by using the Size+Nodes method. Cancer 2009. (c) 2009 American Cancer Society.
长期以来人们已经认识到肿瘤大小、淋巴结状态和患者生存率是相关的特征，尽管如何分离它们之间的相互作用并不明确，而且如何将肿瘤大小和淋巴结状态纳入个体患者死亡风险的预测也不明确。
作者描述了一种基于癌细胞扩散的数学方法，即癌症转移的二元生物学模型，其中的方程描述了肿瘤大小、淋巴结状态和癌症致死性之间的关系。
对于黑色素瘤、肾细胞癌和乳腺癌，肿瘤大小与癌症死亡风险之间的关系由“仅大小”方程描述。对于黑色素瘤和乳腺癌，肿瘤大小与淋巴结中癌症存在之间的关系由“仅淋巴结大小”方程描述。对于淋巴结阴性的黑色素瘤和乳腺癌，肿瘤大小与死亡风险之间的关系由“仅原发肿瘤大小”方程描述。对于乳腺癌，该模型表明每个阳性淋巴结大约增加6%的死亡风险，而原发肿瘤最大直径每增加1毫米大约增加1%的死亡风险。对于黑色素瘤，每个阳性淋巴结大约增加23%的死亡风险，而原发黑色素瘤厚度每增加1毫米大约增加8%的死亡风险。这些信息由一对关联方程“大小 + 淋巴结”方法描述。
如用“大小 + 淋巴结”方法所估计的，肿瘤大小和阳性淋巴结数量均对癌症死亡风险有独立的影响。《癌症》2009年。(c) 2009美国癌症协会。
