Stewart J F, Rubens R D, Millis R R, King R J, Hayward J L
Eur J Cancer Clin Oncol. 1983 Oct;19(10):1381-7. doi: 10.1016/0277-5379(93)90007-r.
Four hundred and forty-seven women with operable (TNM stage I or II) breast cancer in whom oestrogen receptors (ER), progesterone receptors (PgR) or both receptors had been assayed were studied. Receptor status was independent of axillary nodal status, but infiltrating duct carcinomas that were ER-, PgR- or ER-PgR- were more likely to be anaplastic (P less than 0.001). Four hundred patients with follow-up and uniform treatment were analysed for post-operative disease-free interval (DFI) and survival. No significant difference in DFI existed between patients with ER+ and ER- tumours or PgR+ and PgR- tumours, although there was a trend for longer DFI for ER+ and PgR+. DFI was longer in patients with better-differentiated (grade 1 and 2) tumours than with anaplastic (grade 3) tumours. In patients with ER+ tumours, those with grade 1 and 2 tumours had a longer DFI than those with grade 3 tumours (P less than 0.005). Survival was significantly longer in patients with ER+ tumours compared to those with ER- tumours (P less than 0.001), but there was no such association between tumour PgR and survival. Survival of patients with ER+PgR+ tumours was significantly longer than those with ER-PgR- tumours (P less than 0.025) and, in patients with no evidence of axillary nodal involvement, significantly longer than those with ER+PgR- tumours. Survival in patients with nodal involvement was influenced by histological grade, being longer in those with grade 1 or 2 tumours compared to those with grade 3 tumours. For ER+ tumours, survival was longer in patients with grade 1 or 2 than with grade 3 tumours. These results suggest that steroid receptors significantly affect survival but not DFI. This effect is most closely related to ER content, with relatively little additional information accruing from analysis of PgR. Histological grade influences both DFI and survival, and analysis of both grade and ER content may give a more accurate indication of prognosis in operable breast cancer.
对447例患有可手术治疗（TNM分期为I期或II期）乳腺癌且已检测雌激素受体（ER）、孕激素受体（PgR）或两者受体的女性进行了研究。受体状态与腋窝淋巴结状态无关，但ER阴性、PgR阴性或ER-PgR阴性的浸润性导管癌更可能为间变（P<0.001）。对400例接受随访且治疗方式一致的患者分析其术后无病生存期（DFI）和生存率。ER阳性和ER阴性肿瘤患者或PgR阳性和PgR阴性肿瘤患者之间的DFI无显著差异，尽管ER阳性和PgR阳性患者的DFI有延长趋势。高分化（1级和2级）肿瘤患者的DFI长于间变（3级）肿瘤患者。在ER阳性肿瘤患者中，1级和2级肿瘤患者的DFI长于3级肿瘤患者（P<0.005）。与ER阴性肿瘤患者相比，ER阳性肿瘤患者的生存期显著延长（P<0.001），但肿瘤PgR与生存期之间无此关联。ER+PgR+肿瘤患者的生存期显著长于ER-PgR-肿瘤患者（P<0.025），且在无腋窝淋巴结受累证据的患者中，显著长于ER+PgR-肿瘤患者。有淋巴结受累患者的生存期受组织学分级影响，1级或2级肿瘤患者的生存期长于3级肿瘤患者。对于ER阳性肿瘤，1级或2级患者的生存期长于3级肿瘤患者。这些结果表明，类固醇受体显著影响生存期，但不影响DFI。这种影响与ER含量关系最为密切，分析PgR获得的额外信息相对较少。组织学分级影响DFI和生存期，分析分级和ER含量两者可能更准确地指示可手术乳腺癌的预后。
