Departments of Pathology & Laboratory Medicine and Paediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
Cancer Med. 2020 Jul;9(13):4490-4494. doi: 10.1002/cam4.3112. Epub 2020 May 7.
The roots of precision cancer therapy began at the Mayo Clinic in 1914 when surgical pathologist Albert C. Broders began collecting data showing that cancers of the same histologic type behaved differently. In March 1920, based upon 6 years of clinical follow-up, Broders published his first paper, utilizing data from over 500 cases of squamous cell carcinoma of the lip that he had blindly divided into four histologic grades based upon degree of differentiation, showing that numerical tumor "grading" allowed him to predict patient prognosis. Before this, surgeons had no scientific way to evaluate prognosis. Broders then replicated his work using other types of tumors at other body sites, as did several Mayo Fellows and pathologists at other institutions. Cuthbert Dukes in London, England not only replicated Broders' findings with rectal adenocarcinomas, he also used the same data to develop the first tumor "staging" methodology by focusing upon depth of local invasion and presence or absence of lymph node metastases. Soon, tumor grading, tumor staging, or the combination of both represented state-of-the-art prognostic techniques for scientific cancer care. This brief historical vignette celebrates the 100th anniversary of Broders' first paper, which is the starting point for the long road to personalized cancer care.
精准癌症治疗的起源可以追溯到 1914 年的梅奥诊所，当时外科病理学家 Albert C. Broders 开始收集数据，表明同一组织学类型的癌症表现出不同的行为。1920 年 3 月，基于 6 年的临床随访，Broders 发表了他的第一篇论文，该论文利用了他从 500 多例唇鳞状细胞癌患者的数据，根据分化程度将这些数据盲目地分为四个组织学等级，表明肿瘤“分级”可以帮助他预测患者的预后。在此之前，外科医生没有科学的方法来评估预后。Broders 随后在其他身体部位的其他类型肿瘤上复制了他的工作，几位梅奥研究员和其他机构的病理学家也是如此。英格兰伦敦的 Cuthbert Dukes 不仅复制了 Broders 在直肠腺癌方面的发现，还使用相同的数据通过关注局部侵犯的深度和淋巴结转移的存在与否，开发了第一个肿瘤“分期”方法。很快，肿瘤分级、肿瘤分期或两者的结合成为科学癌症治疗的先进预后技术。这个简短的历史片段庆祝了 Broders 第一篇论文发表 100 周年，这是迈向个性化癌症治疗漫长道路的起点。
