Kaufmann M, Feichter G E, Nhila A, Klinga K, Abel U
Universitäts-Frauenklinik, Inst. Exp. Pathologie der Universität Heidelberg.
Geburtshilfe Frauenheilkd. 1988 Oct;48(10):705-9. doi: 10.1055/s-2008-1026613.
The prognostic significance of DNA flow cytometric examinations of 247 patients (mean age 57 years; 27-84) with operable breast cancer was analyzed. The findings were compared with biochemically determined steroid-hormone receptors and lymph node status. Forty-two percent of the tumors were diploid and 58% aneuploid; 32% of them had a high S-phase portion (greater than 5%; definition by the crit-level method). S-phase fractions were lower in diploid than in aneuploid tumors (2.5 +/- 2.2% versus 5.5 +/- 3.4%). Both with diploid tumors as well as tumors with a low S-phase fraction (less than 5%), recurrence-free survival was better than with aneuploid tumors (p = 0.02) and tumors with a high S-phase fraction (p = 0.004). A direct proportional relationship was found between the S-phase fraction and the mean recurrence-free interval. As regards overall survival, no significant differences have been detected so far, either for diploid and aneuploid tumors or tumors with low and high S-phase fractions. Using the Cox regression model, the prognostic significance of ploidy status and S-phase, as new factors, independent of age, lymph node and steroid-hormone receptor status, is shown. DNA flow cytometry is suitable for routine clinical use and should be used in particular as an independent prognostic factor for planning and stratification in adjuvant therapeutic studies.
分析了247例(平均年龄57岁,27 - 84岁)可手术乳腺癌患者的DNA流式细胞术检查的预后意义。将结果与生化测定的类固醇激素受体和淋巴结状态进行比较。42%的肿瘤为二倍体,58%为非整倍体;其中32%具有高S期比例(大于5%;用临界值法定义)。二倍体肿瘤的S期分数低于非整倍体肿瘤(2.5±2.2%对5.5±3.4%)。无论是二倍体肿瘤还是低S期分数(小于5%)的肿瘤,无复发生存率均优于非整倍体肿瘤(p = 0.02)和高S期分数的肿瘤(p = 0.004)。发现S期分数与平均无复发生存期之间存在直接比例关系。至于总生存期,到目前为止,无论是二倍体和非整倍体肿瘤,还是低和高S期分数的肿瘤,均未检测到显著差异。使用Cox回归模型,显示了倍体状态和S期作为新的因素的预后意义,独立于年龄、淋巴结和类固醇激素受体状态。DNA流式细胞术适用于常规临床应用,尤其应作为辅助治疗研究中规划和分层的独立预后因素使用。