Hawkins R A, Black R, Steele R J, Dixon J M, Forrest A P
Breast Cancer Res Treat. 1981;1(3):245-51. doi: 10.1007/BF01806264.
The primary tumour and 1-3 invaded, axillary nodes from each of 24 patients were examined both histologically for the proportion of the specimen constituted by malignant epithelial cells ('cellularity index') and biochemically for oestrogen receptor concentration. Both malignant epithelial cell content and oestrogen receptor concentration were significantly higher in the nodal metastases than in the primary tumours, malignant cells constituting approximately half of the former tissue and three quarters of the latter. On average, receptor concentrations were 1.6 x (protein basis) to 2.3 x (wet weight basis) higher in nodes than in the primary tumours, probably due at least in part to the difference in cellularity. When, to eliminate the effect of the latter, receptor concentration in each tumour deposit was 'corrected' using the appropriate 'cellularity index', the difference in receptor concentration between primary and node was significantly diminished, but not quite eliminated. In one patient, progestogen receptor concentrations were also studied and found to be higher in the nodes than in the primary tumour. If the actual quantity of receptor is to be used for predictive/prognostic purposes, then either a different 'cut-off point' should be used for invaded nodes from that used for assessment on the primary tumour, or receptor concentrations should be corrected for differences in cellularity.
对24例患者的原发性肿瘤以及1 - 3个受累腋窝淋巴结进行了检查，从组织学上检测恶性上皮细胞在标本中所占比例（“细胞密度指数”），并从生化角度检测雌激素受体浓度。淋巴结转移灶中的恶性上皮细胞含量和雌激素受体浓度均显著高于原发性肿瘤，恶性细胞在前者组织中约占一半，在后者中占四分之三。平均而言，淋巴结中的受体浓度（以蛋白质为基础）比原发性肿瘤高1.6倍，（以湿重为基础）高2.3倍，这可能至少部分归因于细胞密度的差异。为消除后者的影响，使用适当的“细胞密度指数”对每个肿瘤沉积物中的受体浓度进行“校正”后，原发性肿瘤与淋巴结之间受体浓度的差异显著减小，但并未完全消除。在一名患者中，还研究了孕激素受体浓度，发现淋巴结中的浓度高于原发性肿瘤。如果要将受体的实际数量用于预测/预后目的，那么对于受累淋巴结应使用与原发性肿瘤评估不同的“临界值”，或者应针对细胞密度差异对受体浓度进行校正。
