Hartmann L C, Ingle J N, Wold L E, Farr G H, Grill J P, Su J Q, Maihle N J, Krook J E, Witzig T E, Roche P C
Department of Oncology, Mayo Clinic, Rochester, Minnesota 55905.
Cancer. 1994 Dec 1;74(11):2956-63. doi: 10.1002/1097-0142(19941201)74:11<2956::aid-cncr2820741111>3.0.co;2-v.
This study was designed to evaluate the prognostic importance of c-erbB2 overexpression in a standardized cohort of patients with axillary lymph node positive breast cancer.
Paraffin embedded primary breast cancers from 354 patients with axillary lymph node positive breast cancer, treated on a North Central Cancer Treatment Group adjuvant protocol, were studied immunohistochemically. c-erbB2 staining was classified as negative, weak (1+), moderate (2+), or strong (3+) and was assessed for effectiveness as a predictor of outcome in univariate and Cox model multivariate analyses.
Twenty percent of specimens exhibited moderate or strong c-erbB2 staining. The median disease free survival period of the strong staining group was 2.9 years, compared with 7.1 years for all other patients (P = 0.01). The median overall survival for the strong staining group was 5 years, compared with 12 years for all other patients (P = 0.03). A definite correlation was noted between degree of nodal involvement and the likelihood of strong c-erbB2 staining (P = 0.001). There was also a significant correlation between c-erbB2 staining and higher nuclear grade and estrogen receptor negativity. In a multivariate analysis, c-erbB2 staining was not a significant predictor of either disease free survival or overall survival.
According to this analysis, the strong correlation between c-erbB2 expression and degree of nodal involvement, higher grade disease, and estrogen receptor negativity suggests expression of this protooncogene product in a biologically more aggressive form of breast cancer. In a multivariate analysis, c-erbB2 expression was not an independent prognostic factor. Thus, c-erbB2 assessment did not appear to add significantly to the information provided by currently available standard disease parameters.
本研究旨在评估c-erbB2过表达在腋窝淋巴结阳性乳腺癌标准化队列患者中的预后重要性。
对354例接受北中部癌症治疗组辅助方案治疗的腋窝淋巴结阳性乳腺癌患者的石蜡包埋原发性乳腺癌进行免疫组织化学研究。c-erbB2染色分为阴性、弱阳性（1+）、中度阳性（2+）或强阳性（3+），并在单变量和Cox模型多变量分析中评估其作为预后预测指标的有效性。
20%的标本显示中度或强c-erbB2染色。强染色组的无病生存期中位数为2.9年，而所有其他患者为7.1年（P = 0.01）。强染色组的总生存期中位数为5年，而所有其他患者为12年（P = 0.03）。注意到淋巴结受累程度与强c-erbB2染色可能性之间存在明确相关性（P = 0.001）。c-erbB2染色与更高的核分级和雌激素受体阴性之间也存在显著相关性。在多变量分析中，c-erbB2染色不是无病生存期或总生存期的显著预测指标。
根据该分析，c-erbB2表达与淋巴结受累程度、更高分级疾病和雌激素受体阴性之间的强相关性表明该原癌基因产物在生物学上更具侵袭性的乳腺癌形式中表达。在多变量分析中，c-erbB2表达不是独立的预后因素。因此，c-erbB2评估似乎并未显著增加目前可用标准疾病参数所提供的信息。
