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一个模拟临床数据的乳腺癌生长随机数值模型。

A stochastic numerical model of breast cancer growth that simulates clinical data.

作者信息

Speer J F, Petrosky V E, Retsky M W, Wardwell R H

出版信息

Cancer Res. 1984 Sep;44(9):4124-30.

PMID:6744323
Abstract

A new stochastic numerical model of breast cancer growth is developed. First, the model suggests that Gompertzian kinetics does apply but that from time to time, in random fashion, there occurs a spontaneous change in the growth rate or rate of decay of growth, such that the overall growth pattern occurs in a stepwise fashion. According to the model, the average time for the tumor burden to increase from one cell to detection is probably in the range of 8 years. Secondly, the model suggests that there is a linear relationship between the number of axillary lymph nodes positive for metastasis at diagnosis and the number of other metastatic sites. This can be described mathematically by the equation S = 0.24 + 0.35N where S is the number of other metastatic sites and N is the number of positive lymph nodes. The model has been verified by simulating three data sets: (a) the survival times of untreated breast cancer patients as described by Bloom et al. [Br. Med. J., 2: 213-221, 1962]; (b) the growth rates of breast cancers immediately prior to diagnosis as described by Heuser and Spratt [Cancer (Phila.), 43: 1888-1894, 1979]; and (c) the disease-free survival time postmastectomy as described by Fisher et al. [Surg. Gynecol. Obstet., 140: 528-534, 1975]. This model could have implications concerning the overall treatment rationale for breast cancer.

摘要

开发了一种新的乳腺癌生长随机数值模型。首先,该模型表明Gompertzian动力学确实适用,但生长速率或生长衰减速率会不时以随机方式发生自发变化,从而使整体生长模式呈阶梯式。根据该模型,肿瘤负荷从一个细胞增加到可检测的平均时间可能在8年左右。其次,该模型表明诊断时腋窝淋巴结转移阳性数量与其他转移部位数量之间存在线性关系。这可以用方程S = 0.24 + 0.35N进行数学描述,其中S是其他转移部位的数量,N是阳性淋巴结的数量。该模型已通过模拟三个数据集得到验证:(a) Bloom等人[《英国医学杂志》,2: 213 - 221, 1962]描述的未经治疗的乳腺癌患者的生存时间;(b) Heuser和Spratt[《癌症(费城)》,43: 1888 - 1894, 1979]描述的乳腺癌在诊断前的生长速率;以及(c) Fisher等人[《外科、妇科与产科》,140: 528 - 534, 1975]描述的乳房切除术后无病生存时间。该模型可能对乳腺癌的整体治疗原理有影响。

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