Division of Pathology, School of Molecular Medical Sciences, University of Nottingham, Nottingham, United Kingdom.
Int J Cancer. 2010 Apr 1;126(7):1761-9. doi: 10.1002/ijc.24860.
Accurate predictive markers of chemotherapeutic response in early breast cancer are still lacking. The role of tumour growth fraction as a predictor of response to chemotherapy was assessed in early breast cancer. In this study, immunohistochemical expression of MIB1 was studied in a well-characterised series of early (Stages I and II) node-negative breast carcinoma cases (n = 100) with long-term follow-up that have received adjuvant chemotherapy (cyclophosphamide/methotrexate/5-fluorouracil regimen). In addition, 728 cases who did not receive adjuvant chemotherapy were used as a control group. Increased tumour growth fraction was associated with a better response to adjuvant chemotherapy in terms of longer breast cancer specific survival and disease-free interval [hazard ratio (HR) = 0.354, 95% CI = 0.177-0.688, p = 0.003 and HR = 0.396, 95% CI = 0.205-0.768, p = 0.006, respectively]. In contrast to the control group, patients with high growth fraction tumour (>70%) showed an excellent outcome with infrequently reported events during the period of follow-up. Importantly, patients with a low growth fraction (< or =10%) showed frequent recurrences and shorter survival time with outcome comparable to those of high growth fraction who did not receive chemotherapy. Therefore, tumour growth fraction can be used to assign patients into distinct groups showing differential response to adjuvant chemotherapy. Patients with a high growth fraction appear to be ideal candidates for adjuvant chemotherapy while those with low growth fraction are less likely to benefit and are prone to the potential serious side effects of adjuvant chemotherapy.
早期乳腺癌中仍缺乏化疗反应的准确预测标志物。本研究评估了肿瘤生长分数作为预测化疗反应的标志物在早期（I 期和 II 期）淋巴结阴性乳腺癌病例中的作用。在这项研究中，对经过长期随访且接受辅助化疗（环磷酰胺/甲氨蝶呤/5-氟尿嘧啶方案）的 100 例早期（I 期和 II 期）淋巴结阴性乳腺癌病例进行了 MIB1 免疫组化表达研究。此外，还使用了 728 例未接受辅助化疗的病例作为对照组。较高的肿瘤生长分数与辅助化疗的更好反应相关，表现为乳腺癌特异性生存和无病间隔时间更长[风险比（HR）=0.354，95%可信区间（CI）=0.177-0.688，p=0.003 和 HR=0.396，95%CI=0.205-0.768，p=0.006]。与对照组相比，高生长分数肿瘤（>70%）的患者在随访期间很少发生事件，预后极好。重要的是，低生长分数（<或=10%）的患者复发频繁，生存时间短，与未接受化疗的高生长分数患者的结果相当。因此，肿瘤生长分数可用于将患者分为对辅助化疗反应不同的亚组。高生长分数的患者似乎是辅助化疗的理想候选者，而低生长分数的患者不太可能受益，且容易出现辅助化疗的潜在严重副作用。
