Klijn J G, Look M P, Portengen H, Alexieva-Figusch J, van Putten W L, Foekens J A
Department of Medical Oncology, Rotterdam Cancer Institute, The Netherlands.
Breast Cancer Res Treat. 1994 Jan;29(1):73-83. doi: 10.1007/BF00666183.
In a study on 214 patients with primary breast cancer (median follow-up 8.5 yr, maximum follow-up 15 yr), EGF-R was negatively correlated to estrogen receptor and progesterone receptor, whereas no association was found with age, lymph node status, and tumor size. Initially, after a follow-up of 5 yr, there was a tendency to a significant association between EGF-R levels and tumor recurrence rate (p = 0.08). Patients with tumors containing intermediate levels of EGF-R experienced a longer relapse-free survival (RFS) than did patients with tumors possessing lower or higher levels of EGF-R. This effect was most pronounced in the subgroup of patients with positive axillary lymph nodes. However, after 10 yr follow-up, this association appears to be lost (p = 0.28) as shown in this update. A similar phenomenon was observed for the ER. While at 5 yr follow-up ER status had significant prognostic value (p = 0.01), at 10 yr follow-up this significance also appears to be lost (p = 0.40). However, tumor size, lymph node status, grade, and PgR status maintained significant prognostic value by univariate analysis. Based on 40 separate studies comprising 5232 patients, the mean percentage of EGF-R positivity reported in breast cancer is 45% (range 14-91%). Nine out of 15 different studies showed in some way a significant negative association between EGF-R and RFS by univariate analysis, and 2 others showed a tendency to such a relationship. Of 7 studies applying multivariate analysis, two demonstrated an independent prognostic value of EGF-R for RFS and two others a tendency to a significant correlation, whereas three did not. It may be concluded that EGF-R status has more or less prognostic value in patients with primary breast cancer, but the prognostic power decreases with longer follow-up. Of great clinical significance is the association of EGF-R with hormone resistance. Therefore EGF-R status can be used for selection of type of treatment. Finally, EGF-R might be useful as a target for new treatment modalities.
在一项针对214例原发性乳腺癌患者的研究中（中位随访时间8.5年，最长随访时间15年），表皮生长因子受体（EGF-R）与雌激素受体和孕激素受体呈负相关，而与年龄、淋巴结状态及肿瘤大小未发现关联。最初，随访5年后，EGF-R水平与肿瘤复发率之间存在显著关联的趋势（p = 0.08）。EGF-R水平处于中等的肿瘤患者比EGF-R水平较低或较高的肿瘤患者无复发生存期（RFS）更长。这种效应在腋窝淋巴结阳性患者亚组中最为明显。然而，如本次更新所示，随访10年后，这种关联似乎消失了（p = 0.28）。雌激素受体（ER）也观察到类似现象。虽然随访5年时ER状态具有显著的预后价值（p = 0.01），但随访10年时这种显著性似乎也消失了（p = 0.40）。然而，通过单因素分析，肿瘤大小、淋巴结状态、分级及孕激素受体（PgR）状态仍保持显著的预后价值。基于40项包括5232例患者的独立研究，乳腺癌中报道的EGF-R阳性的平均百分比为45%（范围14 - 91%）。15项不同研究中的9项通过单因素分析在某种程度上显示EGF-R与RFS之间存在显著负相关，另外2项显示出这种关系的趋势。在7项应用多因素分析的研究中，2项证明EGF-R对RFS具有独立预后价值，另外两项显示出显著相关的趋势，而3项则未显示。可以得出结论，EGF-R状态在原发性乳腺癌患者中或多或少具有预后价值，但随着随访时间延长，预后能力下降。EGF-R与激素抵抗的关联具有重要临床意义。因此，EGF-R状态可用于治疗类型的选择。最后，EGF-R可能作为新治疗模式的靶点。
