Tabar L, Duffy S W, Krusemo U B
Mammography Department, Central Hospital, Falun, Sweden.
Eur J Cancer Clin Oncol. 1987 Jul;23(7):959-62. doi: 10.1016/0277-5379(87)90341-5.
The relationship between tumour size and lymph node metastases was examined in screening-detected and clinically detected breast cancers. The data used were from a randomized trial of breast cancer screening with mammography. 964 cancers were reviewed, in both arms of the trial, in women aged 40-74. Lymph node status was significantly related to detection method (P less than 0.001), metastases being less common in screening-detected cancers. Node status was also significantly related to tumour size (P less than 0.001), metastases being commoner in larger tumours. Similarly, tumour size was significantly associated with detection method (P less than 0.001), smaller tumours being detected by screening. No significant interaction was observed among all three factors, indicating that the relationship between node status and tumour size did not change with detection method. When detection method was replaced with randomly allocated study (invited to screening) and control (not invited to screening) groups, the same results were observed. It is concluded that if screening detects tumours with a different natural history to that of those which surface clinically, this is not reflected in the relationship between tumour size and lymph node metastases.
在筛查发现的和临床发现的乳腺癌中，对肿瘤大小与淋巴结转移之间的关系进行了研究。所使用的数据来自一项乳腺钼靶乳腺癌筛查随机试验。对该试验两组中年龄在40 - 74岁的女性的964例癌症病例进行了回顾。淋巴结状态与检测方法显著相关（P < 0.001），在筛查发现的癌症中转移情况较少见。淋巴结状态也与肿瘤大小显著相关（P < 0.001），在较大肿瘤中转移更常见。同样，肿瘤大小与检测方法显著相关（P < 0.001），较小的肿瘤通过筛查被发现。在所有三个因素之间未观察到显著的相互作用，这表明淋巴结状态与肿瘤大小之间的关系不会因检测方法而改变。当将检测方法替换为随机分配的研究组（受邀参加筛查）和对照组（未受邀参加筛查）时，观察到相同的结果。得出的结论是，如果筛查发现的肿瘤与临床出现的肿瘤具有不同的自然病程，这在肿瘤大小与淋巴结转移之间的关系中并未体现出来。
