Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Breast Cancer. 2020 Nov;27(6):1114-1125. doi: 10.1007/s12282-020-01115-x. Epub 2020 Jun 3.
The 8th edition American Joint Committee on Cancer (AJCC) proposed a prognostic stage (PS), which included not only anatomical factors, but also biological factors. We aimed to investigate the clinicopathological significance of the PS and to compare PS and anatomical stage (AS) that has been established by the Union for International Cancer Control (UICC).
Between 2002 and 2017, 800 patients were included in the study. Patients were classified using pathological UICC AS and pathological AJCC PS. The usefulness of PS in comparison with AS was validated using the Akaike information criterion (AIC) and Harrell concordance index (C-index).
A total of 401 (50.1%) patients had pathological AS I, 324 (40.5%) had AS II, and 75 (9.4%) had AS III. Meanwhile, 535 (66.8%) had pathological PS I, 163 (20.4%) had PS II, and 102 (12.8%) had PS III. The number of AS II cases was 1.99-fold higher than that of PS II cases. For each stage, these survival curves were almost similar between AS and PS classification. Therefore, many patients to be classified into stage I and stage III were included in AS II group, while many patients to be classified into stage II were included in AS I group. To trichotomize the survival groups, PS appeared to be more specific than AS, and AIC and C-index confirmed the speculation.
For the prognostication of primary breast cancer patients, AJCC PS appeared to be able to stratify the cases more appropriately than UICC AS.
第 8 版美国癌症联合委员会（AJCC）提出了一种预后分期（PS），它不仅包括解剖因素，还包括生物因素。我们旨在研究 PS 的临床病理意义，并比较 AJCC 提出的 PS 与国际抗癌联合会（UICC）建立的解剖分期（AS）。
在 2002 年至 2017 年间，共有 800 名患者纳入本研究。患者采用病理 UICC AS 和病理 AJCC PS 进行分类。使用赤池信息量准则（AIC）和哈雷一致性指数（C-index）验证 PS 与 AS 的有效性。
共有 401 例（50.1%）患者的病理 AS I 期，324 例（40.5%）患者的 AS II 期，75 例（9.4%）患者的 AS III 期。同时，535 例（66.8%）患者的病理 PS I 期，163 例（20.4%）患者的 PS II 期，102 例（12.8%）患者的 PS III 期。PS II 期的病例数是 PS II 期的 1.99 倍。对于每个分期，AS 和 PS 分类的生存曲线几乎相似。因此，许多原本应归入 I 期和 III 期的患者被归入 AS II 组，而许多原本应归入 II 期的患者则归入 AS I 组。为了将生存组分为三组，PS 似乎比 AS 更具特异性，AIC 和 C-index 也证实了这一推测。
对于原发性乳腺癌患者的预后预测，AJCC PS 似乎比 UICC AS 更能适当地分层病例。
