Skinner J R, Wanebo H J, Betsill W L, Wilhelm M C, Drake C R, Macleod R M
Ann Surg. 1982 Dec;196(6):636-41. doi: 10.1097/00000658-198212001-00003.
The presence of estrogen receptors in breast cancer tissue has been reported to correlate with improved prognosis in women after mastectomy. The prognostic value (if any) of the presence or absence of estrogen receptors (ER) in malignant breast tissue was evaluated 104 women who were treated for primary breast cancer, whose pathology was re-examined, and whose records were subjected to multifactorial analysis. Sixty patients were ER positive, and 44 were ER negative, and a total of 94 who had curative resections were available for follow-up (mean follow-up time 20 months). The presence of estrogen receptors showed significant positive correlations with age, lobular cancer, and a variant of infiltrating duct cancer that is prevalent in the elderly and characterized by the presence of cells showing granular eosinophilic cytoplasm. Of 26 cases identified as infiltrating duct cancer showing granular eosinophilic cytoplasm, 22 were ER positive, one was ER negative, and three had borderline values. There was no significant difference between the groups with regard to family history of breast cancer or hysterectomy. A striking observation was noted in the ER positive group in which there were seven cases of second primary breast cancers, whereas no such cases occurred in the ER negative patients (p=0.05). There was a higher percentage of nodal metastases in the patients who were ER positive compared with those who were ER negative; 27 of 53 (51%) of the ER positive patients has positive nodes compared with four of 40 (32%) who were ER negative, p = 0.08. There was no significant correlation of disease free survival nor time to recurrence in either the overall group nor according to stage. In patients whose tumors had been reviewed and graded, there was no prognostic relationship of ER status in high grade tumors, but in patients with low-grade tumors, improved disease-free survival was demonstrated in patients who were ER negative. Although the estrogen receptor assay is a highly useful tumor marker and guide for therapy of advanced breast cancer, its relationship to the prognostic variables of primary breast cancer is complex and controversial and merits continued study.
据报道，乳腺癌组织中雌激素受体的存在与乳房切除术后女性预后的改善相关。对104例接受原发性乳腺癌治疗的女性进行了评估，重新检查了她们的病理情况，并对其记录进行多因素分析，以确定恶性乳腺组织中雌激素受体（ER）的存在与否的预后价值（若有）。60例患者ER阳性，44例ER阴性，共有94例行根治性切除的患者可供随访（平均随访时间20个月）。雌激素受体的存在与年龄、小叶癌以及一种在老年人中常见的浸润性导管癌变体呈显著正相关，该变体以存在显示颗粒状嗜酸性细胞质的细胞为特征。在26例被鉴定为显示颗粒状嗜酸性细胞质的浸润性导管癌病例中，22例ER阳性，1例ER阴性，3例为临界值。两组在乳腺癌家族史或子宫切除术方面无显著差异。在ER阳性组中观察到一个显著现象，其中有7例第二原发性乳腺癌病例，而ER阴性患者中未出现此类病例（p = 0.05）。与ER阴性患者相比，ER阳性患者的淋巴结转移百分比更高；53例ER阳性患者中有27例（51%）淋巴结阳性，而40例ER阴性患者中有4例（32%）淋巴结阳性，p = 0.08。无论是在整个组中还是根据分期，无病生存期和复发时间均无显著相关性。在对肿瘤进行评估和分级的患者中，ER状态与高级别肿瘤的预后无相关性，但在低级别肿瘤患者中，ER阴性患者的无病生存期得到改善。尽管雌激素受体检测是一种非常有用的肿瘤标志物和晚期乳腺癌治疗的指导，但它与原发性乳腺癌预后变量的关系复杂且存在争议，值得继续研究。
