van Diest P J, Matze-Cok E, Baak J P
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
J Clin Pathol. 1991 May;44(5):416-8. doi: 10.1136/jcp.44.5.416.
Whether the proliferative activity of distant metastases could be predicted by the proliferation in axillary lymph node metastases was investigated in 304 lymph nodes metastases of 52 patients with breast cancer who had not received adjuvant treatment. The standard deviation of the mean mitotic index (MI)--the average number of mitoses per field in 10 high power fields--was of the best prognostic valve in univariate survival analysis. None of the classic (volume % epithelium and stroma) or morphometric features (nuclear area, nuclear axis ratio. shape factors) provided significant results. In Cox regression analysis a multivariate combination of the mean MI, the SD of the mean MI, and the maximum MI emerged, which provided a satisfying means of differentiating patients with a good (68% survival) and a poor (28% survival) prognosis. Proliferation variables derived from axillary lymph node metastases of patients with breast cancer can predict the clinical course of distant metastases.
在52例未接受辅助治疗的乳腺癌患者的304个淋巴结转移灶中，研究了腋窝淋巴结转移灶的增殖活性是否能够预测远处转移灶的增殖活性。在单因素生存分析中，平均有丝分裂指数（MI）（10个高倍视野中每个视野的平均有丝分裂数）的标准差是最佳的预后指标。经典特征（上皮和间质体积百分比）或形态学特征（核面积、核轴比、形状因子）均未得出显著结果。在Cox回归分析中，出现了平均MI、平均MI的标准差和最大MI的多变量组合，这为区分预后良好（生存率68%）和预后较差（生存率28%）的患者提供了一种令人满意的方法。源自乳腺癌患者腋窝淋巴结转移灶的增殖变量能够预测远处转移灶的临床进程。
