Clinical Trials and Practice Support Division, Pathology Consultation Service, Center for Cancer Control and Information Services, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.
Am J Surg Pathol. 2011 Mar;35(3):325-36. doi: 10.1097/PAS.0b013e31820afab9.
Tumor-stromal fibroblasts have recently been reported to play important roles in the tumor progression of cancer in various organs. The purpose of this study was to investigate whether any characteristic histologic features of tumor-stromal fibroblasts could accurately predict the outcome of 1042 patients with invasive ductal carcinoma of the breast. We observed a small number of tumor-stromal fibroblasts with characteristic nuclear features existing inside and outside of fibrotic foci and named them atypical tumor-stromal fibroblasts. We then classified invasive ductal carcinomas into 4 types (1, 2, 3, and 4) according to the absence or presence of fibrotic foci and the absence or presence of atypical tumor-stromal fibroblasts. We then analyzed the outcome predictive powers of these types of invasive ductal carcinomas using multivariate analyses that included well-known clinicopathologic factors. The multivariate analyses showed that type 4 invasive ductal carcinomas with fibrotic foci and atypical tumor-stromal fibroblasts had significantly higher hazard ratios for tumor recurrence and tumor-related death, independent of the nodal status and histologic grade, and the type 2 invasive ductal carcinomas without fibrotic foci but with atypical tumor-stromal fibroblasts had a significant higher hazard ratio for tumor recurrence among patients with invasive ductal carcinoma with nodal metastasis and those with histologic grade 3 disease. The results of this study clearly indicated that the presence of atypical tumor-stromal fibroblasts, especially in fibrotic foci, is significantly associated with tumor recurrence and tumor-related death of patients with invasive ductal carcinoma of the breast.
肿瘤基质成纤维细胞最近被报道在各种器官的癌症肿瘤进展中发挥重要作用。本研究旨在探讨肿瘤基质成纤维细胞的任何特征性组织学特征是否能准确预测 1042 例浸润性导管癌患者的预后。我们观察到一小部分具有特征性核特征的肿瘤基质成纤维细胞存在于纤维灶内和周围，并将其命名为非典型肿瘤基质成纤维细胞。然后，我们根据有无纤维灶以及有无非典型肿瘤基质成纤维细胞将浸润性导管癌分为 4 型（1 型、2 型、3 型和 4 型）。然后，我们使用包括已知临床病理因素的多变量分析来分析这些浸润性导管癌类型的预后预测能力。多变量分析显示，具有纤维灶和非典型肿瘤基质成纤维细胞的 4 型浸润性导管癌，无论淋巴结状态和组织学分级如何，肿瘤复发和肿瘤相关死亡的危险比均显著升高，而无纤维灶但有非典型肿瘤基质成纤维细胞的 2 型浸润性导管癌，在有淋巴结转移和组织学分级为 3 级的浸润性导管癌患者中，肿瘤复发的危险比显著升高。本研究的结果清楚地表明，非典型肿瘤基质成纤维细胞的存在，特别是在纤维灶中，与浸润性导管癌患者的肿瘤复发和肿瘤相关死亡显著相关。
