Thomas M, Noguchi M, Fonseca L, Kitagawa H, Kinoshita K, Miyazaki I
Department of Surgery (II) Kanazawa University Hospital, Japan.
Br J Cancer. 1993 Sep;68(3):621-6. doi: 10.1038/bjc.1993.397.
We investigated the prognostic significance of Helix pomatia lectin (HPA) staining on disease-free and overall survival in 120 primary breast carcinomas. HPA staining was present in 58 (48%) of these carcinomas. It was significantly associated with axillary lymph node metastases (P < 0.001) and c-erbB-2 expression (P < 0.01). A univariate study revealed that disease-free and overall survival were significantly correlated with clinical stage, tumour size, axillary lymph node metastases. HPA staining and c-erbB-2 expression. In a multivariate study, all previous prognostic indicators except HPA staining and c-erbB-2 expression were independent factors. However, stratifying the patients on the basis of HPA and c-erbB-2 status suggested that HPA +/c-erbB-2+ status was predictive of a higher incidence of axillary lymph node metastases (P = 0.000001) and a poorer overall (P < 0.0002) and a shorter disease-free (P < 0.000006) survival when compared with the other subgroups, although this combination did not provide any additional prognostic information for overall (P = 0.3544) or disease-free (P = 0.7152) survival by a multivariate analysis. For patients in whom axillary lymph node dissection has not been performed, therefore, HPA and c-erbB-2 status seems to be a powerful tool to discriminate subpopulations with a high recurrence risk and shorter survival who should undergo more aggressive therapy.
我们研究了蜗牛凝集素(HPA)染色对120例原发性乳腺癌无病生存期和总生存期的预后意义。这些乳腺癌中有58例(48%)存在HPA染色。它与腋窝淋巴结转移(P < 0.001)和c-erbB-2表达(P < 0.01)显著相关。单因素研究显示,无病生存期和总生存期与临床分期、肿瘤大小、腋窝淋巴结转移、HPA染色和c-erbB-2表达显著相关。多因素研究中,除HPA染色和c-erbB-2表达外,所有先前的预后指标均为独立因素。然而,根据HPA和c-erbB-2状态对患者进行分层显示,与其他亚组相比,HPA +/c-erbB-2+状态预示腋窝淋巴结转移发生率更高(P = 0.000001)、总生存期更差(P < 0.0002)且无病生存期更短(P < 0.000006),尽管多因素分析显示该组合对总生存期(P = 0.3544)或无病生存期(P = 0.7152)未提供任何额外的预后信息。因此,对于未进行腋窝淋巴结清扫的患者,HPA和c-erbB-2状态似乎是一种有力工具,可用于区分具有高复发风险和较短生存期、应接受更积极治疗的亚人群。