Ownby D R, Ownby H E, Bailey J, Frederick J, Tilley B, Brooks S C, Russo J, Heppner G, Brennan M
J Natl Cancer Inst. 1985 Oct;75(4):655-63.
Serum concentrations of IgG, IgA, IgM, IgE, and allergen-specific IgE were measured in presurgical serum samples from 400 women admitted to a multidisciplinary study of primary breast cancer. The relationships between the serum immunoglobulins and patient survival were analyzed with the use of a Cox proportional hazards linear model. After adjustment for TNM stage, tumor histopathologic grade, and estrogen receptor (E2R) status, lower IgM concentrations were associated with longer survival. Lower IgE concentrations were also associated with longer survival, but only in patients whose tumors were E2R positive. IgG and IgA were not related to survival. Serum IgM and IgE concentrations, allergen-specific IgE scores, and the tumor E2R status were combined to construct a three-level risk classification that was more prognostic than any of the individual components. Cox model analysis demonstrated that this combination of immunologic and hormonal variables provided significant new information beyond that obtained from TNM staging and histopathologic grading of the tumors (P = .01). This new information may be useful to physicians in advising patients with primary, operable breast cancer about the relative risks and benefits of adjuvant therapy and in designing clinical trials of adjuvant therapy.
在400名接受原发性乳腺癌多学科研究的女性患者的术前血清样本中，检测了IgG、IgA、IgM、IgE和过敏原特异性IgE的血清浓度。使用Cox比例风险线性模型分析血清免疫球蛋白与患者生存率之间的关系。在调整TNM分期、肿瘤组织病理学分级和雌激素受体（E2R）状态后，较低的IgM浓度与较长的生存期相关。较低的IgE浓度也与较长的生存期相关，但仅在肿瘤为E2R阳性的患者中如此。IgG和IgA与生存率无关。将血清IgM和IgE浓度、过敏原特异性IgE评分以及肿瘤E2R状态相结合，构建了一个三级风险分类，其预后比任何单个成分都更好。Cox模型分析表明，这种免疫和激素变量的组合提供了超出肿瘤TNM分期和组织病理学分级所获得的显著新信息（P = 0.01）。这些新信息可能有助于医生就辅助治疗的相对风险和益处向患有原发性可手术乳腺癌的患者提供建议，并有助于设计辅助治疗的临床试验。
