肿瘤微血管密度、p53表达、肿瘤大小及肿瘤周围淋巴管浸润是无淋巴结转移乳腺癌的相关预后标志物。

Tumor microvessel density, p53 expression, tumor size, and peritumoral lymphatic vessel invasion are relevant prognostic markers in node-negative breast carcinoma.

作者信息

Gasparini G, Weidner N, Bevilacqua P, Maluta S, Dalla Palma P, Caffo O, Barbareschi M, Boracchi P, Marubini E, Pozza F

机构信息

St Bortolo Regional Medical Center, Vicenza, Italy.

出版信息

J Clin Oncol. 1994 Mar;12(3):454-66. doi: 10.1200/JCO.1994.12.3.454.

DOI:10.1200/JCO.1994.12.3.454

PMID:7509851

Abstract

PURPOSE

To determine the absolute and relative value of microvessel density (MVD), p53 and c-erbB-2 protein expression, peritumoral lymphatic vessel invasion (PLVI), and conventional prognosticators in predicting relapse-free (RFS) and overall survival (OS) rates in patients with node-negative breast carcinoma (NNBC).

PATIENTS AND METHODS

We monitored 254 consecutive patients with NNBC for a median of 62 months. Intratumoral MVD was measured after microvessels were immunostained using anti-CD31 antibody. p53 and c-erbB-2 protein and hormone receptors were also determined immunocytochemically. Results were analyzed by both univariate and multivariate statistical analysis.

RESULTS

Univariate analysis showed that MVD was significantly predictive of both RFS (odds ratio [OR], 8.30; P = .0001) and OS (OR, 4.50; P = .012) when tested as a continuous or dichotomous variable. Likewise, tumor size (OR, 3.16; P = .0012), PLVI (OR, 4.36; P = .0009), estrogen receptor (ER) status (OR, 2.35; P = .016), progesterone receptor (PR) status (OR, 2.00; P = .017), and expression of p53 protein (OR, 2.82; P = .004) were significantly associated with RFS. Tumor size (OR, 3.80; P = .0038) and expression of p53 protein (OR, 2.58; P = .024) were significantly associated with OS by univariate analysis. Multivariate analysis showed that MVD (P = .0004), p53 protein expression (P = .0063), tumor size (P = .0144), and PLVI (P = .0033) were all significant and independent prognostic factors for RFS. However, only tumor size (P = .004) and MVD (P = .047) were independent predictors for OS. c-erbB2 expression was not associated with outcome by either univariate or multivariate analysis.

CONCLUSION

MVD, p53 expression, PLVI, and tumor size are independent prognostic indicators of recurrence, which are useful in selection of high-risk NNBC patients who may be eligible to receive adjuvant therapies.

摘要

目的

确定微血管密度（MVD）、p53和c-erbB-2蛋白表达、瘤周淋巴管浸润（PLVI）以及传统预后因素在预测淋巴结阴性乳腺癌（NNBC）患者无复发生存率（RFS）和总生存率（OS）方面的绝对和相对价值。

患者与方法

我们连续监测了254例NNBC患者，中位随访时间为62个月。使用抗CD31抗体对微血管进行免疫染色后测量瘤内MVD。还通过免疫细胞化学方法测定p53和c-erbB-2蛋白以及激素受体。结果通过单因素和多因素统计分析进行分析。

结果

单因素分析显示，当将MVD作为连续变量或二分变量进行检测时，其对RFS（优势比[OR]，8.30；P = 0.0001）和OS（OR，4.50；P = 0.012）均具有显著预测性。同样，肿瘤大小（OR，3.16；P = 0.0012）、PLVI（OR，4.36；P = 0.0009）、雌激素受体（ER）状态（OR，2.35；P = 0.016）、孕激素受体（PR）状态（OR，2.00；P = 0.017）以及p53蛋白表达（OR，2.82；P = 0.004）与RFS显著相关。通过单因素分析，肿瘤大小（OR，3.80；P = 0.0038）和p53蛋白表达（OR，2.58；P = 0.024）与OS显著相关。多因素分析显示，MVD（P = 0.0004）、p53蛋白表达（P = 0.0063）、肿瘤大小（P = 0.0144）和PLVI（P = 0.0033）均为RFS的显著且独立的预后因素。然而，只有肿瘤大小（P = 0.004）和MVD（P = 0.047）是OS的独立预测因素。c-erbB2表达在单因素或多因素分析中均与预后无关。