Silverstein M J, Poller D N, Waisman J R, Colburn W J, Barth A, Gierson E D, Lewinsky B, Gamagami P, Slamon D J
Gloucestershire Royal Hospital, UK.
Lancet. 1995 May 6;345(8958):1154-7. doi: 10.1016/s0140-6736(95)90982-6.
We present a new prognostic classification designated the Van Nuys classification for ductal carcinoma-in-situ (DCIS). The classification combines high nuclear grade and comedo-type necrosis to predict clinical recurrence. Three groups of DCIS patients were defined by the presence or absence of high nuclear grade and comedo-type necrosis: 1--non-high-grade DCIS without comedo-type necrosis, 2--non-high-grade DCIS with comedo-type necrosis, 3--high-grade DCIS with or without comedo-type necrosis. There were 31 local recurrences in 238 patients after breast-conservation surgery 3.8% (3/80) in group 1, 11.1% (10/90) in group 2, and 26.5% (18/68) in group 3. The 8-year actuarial disease-free survivals were 93%, 84%, and 61%, respectively (all p < or = 0.05). The Van Nuys classification defines three distinct and easily recognisable groups, each of which has a different likelihood of local recurrence if treated with breast conservation.
我们提出了一种新的预后分类方法，即用于导管原位癌（DCIS）的范奈斯分类法。该分类法结合了高核分级和粉刺样坏死来预测临床复发情况。根据高核分级和粉刺样坏死的有无，将DCIS患者分为三组：1组——无粉刺样坏死的非高级别DCIS，2组——有粉刺样坏死的非高级别DCIS，3组——有或无粉刺样坏死的高级别DCIS。在238例行保乳手术的患者中，有31例出现局部复发，1组为3.8%（3/80），2组为11.1%（10/90），3组为26.5%（18/68）。8年无病生存率分别为93%、84%和61%（所有p≤0.05）。范奈斯分类法定义了三个不同且易于识别的组，每组如果采用保乳治疗，其局部复发的可能性各不相同。
