Pinder S E, Ellis I O, Galea M, O'Rouke S, Blamey R W, Elston C W
Department of Histopathology, City Hospital, Nottingham, UK.
Histopathology. 1994 Jan;24(1):41-7. doi: 10.1111/j.1365-2559.1994.tb01269.x.
The invasion of vascular spaces (lymphatic and/or blood vessel) by tumour, as assessed on routine haematoxylin and eosin sections, was investigated in a consecutive series of 1704 women with primary operable invasive breast carcinoma. Strict morphological criteria were used. Patients were under 70 years of age and received definitive surgery with no adjuvant systemic therapies. Information from regular follow-up (range 3-17 years) was recorded on to a computer database. Definite vascular invasion was seen in 22.8% of cases and concurrence between pathologists was high. In univariate analyses, vascular invasion was strongly associated with lymph node stage (P < 0.0001), tumour size (P < 0.0001), histological grade (P < 0.0001) and type of tumour (P < 0.0001). In multivariate analyses vascular invasion was of independent prognostic significance for both survival and for local recurrence of tumour; patients with tumours showing no vascular invasion had a significant survival advantage and a reduced risk of local recurrence. No association with oestrogen receptor status or menopause status was seen. The results confirm that histological assessment of vascular invasion provides independent prognostic information in primary operable breast carcinoma which may be helpful in making clinical decisions.
在1704例原发性可手术浸润性乳腺癌女性患者的连续系列研究中，通过常规苏木精和伊红切片评估肿瘤对血管间隙（淋巴管和/或血管）的侵犯情况。采用了严格的形态学标准。患者年龄在70岁以下，接受了根治性手术，未接受辅助性全身治疗。将定期随访（范围3 - 17年）的信息记录到计算机数据库中。22.8%的病例出现明确的血管侵犯，病理学家之间的一致性较高。在单变量分析中，血管侵犯与淋巴结分期（P < 0.0001）、肿瘤大小（P < 0.0001）、组织学分级（P < 0.0001）和肿瘤类型（P < 0.0001）密切相关。在多变量分析中，血管侵犯对生存和肿瘤局部复发均具有独立的预后意义；肿瘤未显示血管侵犯的患者具有显著的生存优势和降低的局部复发风险。未发现与雌激素受体状态或绝经状态相关。结果证实，血管侵犯的组织学评估可为原发性可手术乳腺癌提供独立的预后信息，这可能有助于做出临床决策。
