Coombes R C, Berger U, Mansi J, Redding H, Powles T J, Neville A M, McKinna A, Nash A G, Gazet J C, Ford H T
NCI Monogr. 1986(1):51-3.
Metastatic breast cancer cells were found in the bone marrow of 60 (23%) of 269 patients with primary breast cancer, none of whom had metastatic disease disclosed by any other investigation, including bone scanning and radiological skeletal survey. We estimated the number of cancer cells as less than or more than 20 cancer cells seen. Twenty-six patients had less than 20 cancer cells present, and 34 had 20 or more. At a median follow-up time of 22 months, 53 patients had relapsed, 19 of 60 (31.7%) in the group found to have micrometastases and 34 of 195 (17.2%) in the group that had normal bone marrow. Patients with micrometastases are relapsing at a faster rate than those without micrometastases (P = less than 0.05). Patients with less than 20 cancer cells present are relapsing faster than those with no cancer cells but slower than those with 20 or more cancer cells (P = less than 0.01). We conclude that the presence of cancer cells in the marrow at primary diagnosis is a prognostic factor in patients with primary breast cancer.
在269例原发性乳腺癌患者中，60例（23%）的骨髓中发现了转移性乳腺癌细胞，这些患者通过包括骨扫描和骨骼放射学检查在内的任何其他检查均未发现有转移疾病。我们将癌细胞数量估计为少于或多于所见到的20个癌细胞。26例患者的癌细胞数量少于20个，34例患者的癌细胞数量为20个或更多。在中位随访时间22个月时，53例患者复发，在发现有微转移的60例患者中有19例（31.7%）复发，在骨髓正常的195例患者中有34例（17.2%）复发。有微转移的患者比无微转移的患者复发速度更快（P<0.05）。癌细胞数量少于20个的患者比无癌细胞的患者复发更快，但比癌细胞数量为20个或更多的患者复发慢（P<0.01）。我们得出结论，原发性诊断时骨髓中存在癌细胞是原发性乳腺癌患者的一个预后因素。
