Singhakowinta A, Saunders D E, Brooks S C, Samal B, Vaitkevicius V K
Cancer. 1980 Dec 15;46(12 Suppl):2932-8. doi: 10.1002/1097-0142(19801215)46:12+<2932::aid-cncr2820461439>3.0.co;2-0.
Patients with ER positive primary tumors usually have initial metastases at the more favorable sites. Twelve out of 14 patients with ER positive had first site of metastases in either bone or soft tissue. In contrast, 13 of 17 patients with negative ER developed first metastases in viscera. ER positive patients respond better to endocrine therapy and survived twice as long as negative ER patients from the onset of recurrent cancer until death. ER content is not a sufficient criterion for the prediction of the response to endocrine manipulation but serves as useful supplementary information to clinical judgement in to selection of systemic therapy. Prior employment of radiation therapy or the administration of hormones or antihormones, as well as inadequate tumor cells in the specimen and poor procurement of the tumor, can produce spuriously low ER. A protocol to study simultaneous endocrine and chemotherapy in comparison to the sequential approach of endocrine treatment followed by chemotherapy in ER positive patients is desirable.
雌激素受体（ER）阳性原发性肿瘤患者通常在更有利的部位发生初始转移。14例ER阳性患者中有12例的首个转移部位在骨骼或软组织。相比之下，17例ER阴性患者中有13例的首个转移部位在内脏。ER阳性患者对内分泌治疗反应更好，从复发性癌症发作到死亡的生存期是ER阴性患者的两倍。ER含量不是预测内分泌治疗反应的充分标准，但可作为临床判断选择全身治疗时有用的补充信息。先前使用放射治疗、给予激素或抗激素，以及标本中肿瘤细胞不足和肿瘤取材不佳，都可能导致ER假性降低。对于ER阳性患者，研究同时进行内分泌治疗和化疗并与内分泌治疗后序贯化疗的方法进行比较的方案是可取的。
