Zajicek G
Med Hypotheses. 1985 Sep;18(1):79-89. doi: 10.1016/0306-9877(85)90122-7.
From the third year after its clinical diagnosis and onward the cancer hazard rate continuously declines. This phenomenon is common to all cancers irrespective of stage, and far less pronounced in other chronic diseases. It is so typical of cancer as to be regarded as a "law of the improving chances of the cancer patient". Although the cancer hazard rate itself is higher than in most other chronic diseases, it always declines while in other chronic diseases it rises. Two kinds of processes operate in cancer: a noxa and host resistance. Throughout cancer progression the organism maintains a delicate equilibrium with the noxa, only its reserves are continuously depleted and when exhausted the noxa overpowers the host's resistance and the patient dies. The hazard rate is inversely proportional to the patient's reserve. Its decline indicates that the host resists the noxa better and better, since however his reserves are limited, he ultimatelly succumbs to it. This phenomenon also shapes cancer age specific incidence and mortality rates. From the age of 15 years and onward the curves ascend in an exponential fashion, gradually tapering off, which is viewed here as a token of a mounting resistance of the organism to the carcinogenic noxa. Host resistance operates also during tumor growth, accounting for the Gompertzian shape of its growth curve. The growth rate of most human tumors progressively decreases and is therefore best described by the Gompertz function which initially rises in an exponential fashion and gradually tapers off. Tumor size and growth rate indirectly reflect the host's condition or reserve. The two tumor attributes are related to the hazard rate in the following manner: Tumor size is proportional to the hazard rate, indicating host reserve. Tumor growth rate is proportional to the hazard rate change, indicating host resistance. Both indicators may be estimated independently and applied to the assessment of the host's reserve and resistance during cancer progression.
从临床诊断后的第三年起，癌症风险率持续下降。这种现象在所有癌症中都很常见，与癌症分期无关，而在其他慢性疾病中则远没有那么明显。它是癌症的典型特征，以至于被视为“癌症患者预后改善规律”。尽管癌症风险率本身高于大多数其他慢性疾病，但它总是下降，而其他慢性疾病的风险率则上升。癌症中有两种过程在起作用：病因和宿主抵抗力。在整个癌症进展过程中，机体与病因保持着微妙的平衡，只是其储备不断被消耗，当储备耗尽时，病因就会战胜宿主的抵抗力，患者就会死亡。风险率与患者的储备成反比。其下降表明宿主对病因的抵抗力越来越好，因为无论他的储备多么有限，最终他还是会屈服于病因。这种现象也塑造了癌症的年龄别发病率和死亡率曲线。从15岁起，这些曲线呈指数上升，然后逐渐变平，在这里被视为机体对致癌病因抵抗力增强的标志。宿主抵抗力在肿瘤生长过程中也起作用，这解释了肿瘤生长曲线的Gompertzian形状。大多数人类肿瘤的生长速率逐渐降低，因此最好用Gompertz函数来描述，该函数最初呈指数上升，然后逐渐变平。肿瘤大小和生长速率间接反映了宿主的状况或储备。这两个肿瘤特征与风险率的关系如下：肿瘤大小与风险率成正比，表明宿主储备。肿瘤生长速率与风险率变化成正比，表明宿主抵抗力。这两个指标都可以独立估计，并应用于评估癌症进展过程中宿主的储备和抵抗力。
