Pathology Consultation Service, Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo 104-0045, Japan.
Hum Pathol. 2010 May;41(5):706-15. doi: 10.1016/j.humpath.2009.10.015. Epub 2010 Jan 8.
The purpose of this study was to confirm that the grading system for lymph vessel tumor emboli is a significant histologic outcome predictor for patients with invasive ductal carcinoma. The subjects of this study were 1042 invasive ductal carcinoma patients who did not receive neoadjuvant therapy. We classified all invasive ductal carcinomas according to the grading system for lymph vessel tumor emboli we devised, and performed multivariate analyses with well-known prognostic factors. Of 1042 carcinomas, 666, 250, 97, and 29 were classified according to the grading system for lymph vessel tumor emboli as grade 0 (no lymph vessel invasion), grade 1, grade 2, and grade 3, respectively. The univariate analyses showed that the difference in outcome between the group with grade 0 and the group with grade 1 was not significant, but that survival time was significantly shorter in the group of patients with grade 2 carcinomas than in the group with grade 1 carcinomas and significantly shorter in the group of patients with grade 3 carcinomas than in the group with grade 2 carcinomas. Multivariate analyses demonstrated that having a grade 2 or grade 3 carcinoma significantly increased the hazard rates for tumor recurrence and tumor-related death in the patients as a whole as well as in both the group of patients with nodal metastasis and the group without nodal metastasis. The grading system for lymph vessel tumor emboli is an excellent histologic grading system for predicting the outcome of patients with invasive ductal carcinoma of the breast.
本研究旨在证实淋巴管肿瘤栓子分级系统是浸润性导管癌患者重要的组织学预后预测指标。本研究的对象为 1042 例未接受新辅助治疗的浸润性导管癌患者。我们根据我们设计的淋巴管肿瘤栓子分级系统对所有浸润性导管癌进行分类，并结合已知的预后因素进行多变量分析。在 1042 例癌中，666、250、97 和 29 例分别根据淋巴管肿瘤栓子分级系统分为 0 级（无淋巴管浸润）、1 级、2 级和 3 级。单因素分析显示，0 级和 1 级组之间的预后差异不显著，但 2 级癌组的生存时间明显短于 1 级癌组，3 级癌组的生存时间明显短于 2 级癌组。多变量分析表明，2 级或 3 级癌显著增加了所有患者、有淋巴结转移患者和无淋巴结转移患者肿瘤复发和肿瘤相关死亡的危险率。淋巴管肿瘤栓子分级系统是预测乳腺浸润性导管癌患者预后的一种优秀的组织学分级系统。
