Spratt J S, Greenberg R A, Heuser L S
Cancer Res. 1986 Feb;46(2):970-4.
The purpose of this study is to report the time elapsing between the moment a breast cancer reaches threshold size that would permit detection and the size at actual detection defined as sojourn time (STt) using data from the Breast Cancer Detection and Demonstration Project (Louisville data and reported composite data from 27 centers) by dividing prevalence rates by incidence rates. The number of cellular generations (n) required to produce cancers of different volumes was calculated at threshold (nt), at detection (nd), and the difference between the two (nd - nt). By dividing the difference (nd - nt) into STt, the average actual or net tumor volume doubling time (DTact) in this interval have been estimated. The STt value for carcinoma in situ was 557 and for cancer it was 538. At ages 35-39, STt ranged from 365-456 days, by ages 70-74, 942-1383 days. The average DTact similarly varied with age, carcinoma in situ, cancer with negative axillary nodes, and cancer with positive axillary nodes over a range of 28-732 days (95% confidence). The estimated DTact in the predetectable period was manyfold less than the DTact measured for mammographically visible cancers, in keeping with the predictions of decelerating growth. Models of the cytokinetic and clinical behavior of breast cancer are discussed.
本研究的目的是利用乳腺癌检测与示范项目的数据（路易斯维尔数据以及来自27个中心报告的综合数据），通过将患病率除以发病率，报告乳腺癌达到可检测阈值大小的时刻与实际检测时的大小之间所经历的时间，即滞留时间（STt）。计算在阈值时（nt）、检测时（nd）产生不同体积癌症所需的细胞代数（n），以及两者之间的差值（nd - nt）。通过将差值（nd - nt）除以STt，估算出该时间段内平均实际或净肿瘤体积倍增时间（DTact）。原位癌的STt值为557，癌症的STt值为538。在35 - 39岁年龄段，STt范围为365 - 456天，在70 - 74岁年龄段，为942 - 1383天。平均DTact同样随年龄、原位癌、腋窝淋巴结阴性的癌症以及腋窝淋巴结阳性的癌症而变化，范围在28 - 732天（95%置信区间）。在可检测前期估算的DTact比通过乳房X线摄影可见的癌症所测量的DTact小很多倍，这与生长减速的预测相符。讨论了乳腺癌的细胞动力学和临床行为模型。
