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[PS2作为1065例人类乳腺癌的预后因素。一项多中心研究]

[PS2 as a prognostic factor in 1065 cases of human breast cancer. A multicenter study].

作者信息

Besse G, Kwiatkowski F, Gaillard G, Daver A, Dalifard I, Basuyau J P, Brunelle P, Wafflart J, Angibeau R M, Auvray E

机构信息

Centre Jean-Perrin, Clermont-Ferrand, France.

出版信息

Bull Cancer. 1994 Apr;81(4):289-96.

PMID:7703545
Abstract

pS2 protein assay was performed with Elsa-pS2 kit (CIS-Biointernational) on a group of 1,065 patients with operable breast cancer who underwent breast surgery in the years 1982 through 1990. The median follow-up was 57 months. This group included exclusively infiltrating ductal carcinoma with primary surgery. Age mean was 58 yr; T0-T1, 33.6%; T2-T4, 66.4%; Differentiation grade I, 29%; node negative, 53%; estrogen receptor (ER) positive, 62.4%; progesterone receptor (PR) positive, 55.2%; mean tumor size, 2.4 cm; local recurrence, 5.2%; metastasis, 17.5%. pS2 values varied from 0.1 to 707 ng/mg of cytosol protein (median, 5.6; mean 24.5; 95th percentile 112 ng/mg p). There was no significant relationship between the mean level of pS2 and age, tumor size, nodal status, whereas pS2 was related to histological grade (P < 10(-3)), ER (P < 10(-5)), and PR (P < 10(-5)). By using 2 ng/mg p as pS2 cutoff, 77/391 (19.7%) of ER+PR+ tumors were pS2-, and 122/345 (35.4%) of ER-PR-tumors were pS2+; with this cutoff, a strong relationship existed between pS2 and overall survival, but not between pS2 and relapse-free survival. With Cox multivariate analysis, pS2 protein was classified after lymph node status, histological size, ER, differentiation grade, age, clinical stage, PR. In patients with axillary lymph node involvement (N+), pS2 status could discriminate between good and bad prognosis, specially for patients with small tumors (< 2 cm) and with less than seven invaded nodes. This study showed that pS2 protein was a poor prognostic factor in comparison with classical factors.

摘要

使用Elsa-pS2试剂盒(CIS-生物国际公司)对1982年至1990年间接受乳房手术的1065例可手术乳腺癌患者进行了pS2蛋白检测。中位随访时间为57个月。该组仅包括接受初次手术的浸润性导管癌。平均年龄为58岁;T0-T1期占33.6%;T2-T4期占66.4%;分化I级占29%;无淋巴结转移占53%;雌激素受体(ER)阳性占62.4%;孕激素受体(PR)阳性占55.2%;平均肿瘤大小为2.4 cm;局部复发率为5.2%;转移率为17.5%。pS2值在0.1至707 ng/mg胞浆蛋白之间(中位数为5.6;平均值为24.5;第95百分位数为112 ng/mg p)。pS2的平均水平与年龄、肿瘤大小、淋巴结状态之间无显著关系,而pS2与组织学分级(P < 10⁻³)、ER(P < 10⁻⁵)和PR(P < 10⁻⁵)有关。以2 ng/mg p作为pS2临界值,77/391(19.7%)的ER+PR+肿瘤为pS2阴性,122/345(35.4%)的ER-PR-肿瘤为pS2阳性;以此临界值,pS2与总生存期之间存在强相关性,但与无复发生存期之间无相关性。通过Cox多因素分析,pS2蛋白在淋巴结状态、组织学大小、ER、分化程度、年龄、临床分期、PR之后进行分类。在腋窝淋巴结受累(N+)的患者中,pS2状态可区分预后好坏,特别是对于肿瘤较小(< 2 cm)且受累淋巴结少于7个的患者。该研究表明,与经典因素相比,pS2蛋白是一个不良预后因素。

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