Tubiana M, Pejovic M J, Renaud A, Contesso G, Chavaudra N, Gioanni J, Malaise E P
Cancer. 1981 Mar 1;47(5):937-43. doi: 10.1002/1097-0142(19810301)47:5<937::aid-cncr2820470520>3.0.co;2-6.
The correlation between the labeling index (LI) of the primary mammary tumor and the course of the disease after initial treatment was studied prospectively on 128 patients. The surgical specimens of breast tumors were incubated in vitro with tritiated thymidine and autoradiographies were performed. Patients were treated by a simple mastectomy and axillary lymph nodes dissection; patients in whom one or more lymph nodes were found to be involved received postoperative radiotherapy. None of the patients received adjuvant chemotherapy. As the LIs were not known at the time of treatment, their values did not influence the choice of therapy. The follow-up period is greater than six years for all patients. The higher the LI, the shorter were the time intervals from initial treatment to first relapse or from first relapse to death. Moreover, significant correlations were found between the LI and the relapse-free survival and the survival rates. The proportion of relapses was particularly small in the group with the low LI. The shape of the curve suggests that the outcome in this group will be better than that in the group with a high or a median LI. The LI kept its prognostic value after multiple adjustments for other prognostic factors such as the staging, the size of the tumor, the number of metastasis bearing axillary lymph nodes, the presence of an inflammatory reaction, and hormonal status. The LI is significantly correlated with the histologic grading and in particular with its mitotic components. Thus, proliferative activity assessed by LI or the mitotic index appears to provide significant independent prognostic information.
对128例患者进行了前瞻性研究，以探讨原发性乳腺肿瘤的标记指数（LI）与初始治疗后疾病进程之间的相关性。将乳腺肿瘤的手术标本与氚标记的胸腺嘧啶核苷进行体外孵育，并进行放射自显影。患者接受单纯乳房切除术和腋窝淋巴结清扫术；发现一个或多个淋巴结受累的患者接受术后放疗。所有患者均未接受辅助化疗。由于治疗时LI未知，其值不影响治疗方案的选择。所有患者的随访期均超过6年。LI越高，从初始治疗到首次复发或从首次复发到死亡的时间间隔越短。此外，还发现LI与无复发生存率和生存率之间存在显著相关性。LI低的组中复发比例特别小。曲线形状表明，该组的预后将优于LI高或中等的组。在对其他预后因素（如分期、肿瘤大小、有转移的腋窝淋巴结数量、炎症反应的存在和激素状态）进行多次调整后，LI仍保持其预后价值。LI与组织学分级显著相关，特别是与其有丝分裂成分相关。因此，通过LI或有丝分裂指数评估的增殖活性似乎提供了重要的独立预后信息。
