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[乳腺癌患者病理预后因素与复发率之间的时间依赖性相互关系]

[Time-dependent interrelationships between pathological prognostic factors and relapse rate in breast cancer patients].

作者信息

Yoshimoto M

机构信息

Surgical Department, Cancer Institute Hospital, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1993 Oct;94(10):1131-43.

PMID:8232187
Abstract

Eleven pathological factors among 462 patients with primary breast carcinoma (1960-1968) were analysed paying a special attention to changes of the influence on relapse. Factors were included; tumor size (T), extent of nodal involvement (N), nuclear grade (NG), fat infiltration (F), tumor infiltrating lymphocyte (TIL), tumor necrosis (NEC), lymphatic & vessel permeation (LY) and others. Cox regression analysis on 3 non-overlapping intervals (within 2 years, 2-5 years and after 5 years) using the seven factors selected by Cox analysis in the whole periods under the condition of p < 0.10 showed that significant factors were N, NG and T within 2 years, N, TIL, NG and NEC in 2-5 years, F, N, TIL and T after 5 years, respectively (p < 0.05), in the following order. TIL means the relapse suppressing factor and others mean relapse factors. As for the changes of beta value, it decreased with time for N and NG, but contrarily increased with time for F. This means that N and NG participate mainly in an early relapse and F mainly in a delayed relapse. TIL showed a significant relapse suppressing factor only after 2 years. These results revealed that prognostic factors have its altered influence on relapse with time, namely a distinct time-dependency.

摘要

对462例原发性乳腺癌患者(1960 - 1968年)的11个病理因素进行了分析,特别关注其对复发影响的变化。这些因素包括:肿瘤大小(T)、淋巴结受累程度(N)、核分级(NG)、脂肪浸润(F)、肿瘤浸润淋巴细胞(TIL)、肿瘤坏死(NEC)、淋巴管浸润(LY)等。在p < 0.10的条件下,对整个时期通过Cox分析选择的七个因素,在3个非重叠时间段(2年内、2 - 5年和5年后)进行Cox回归分析,结果显示,2年内的显著因素依次为N、NG和T;2 - 5年为N、TIL、NG和NEC;5年后为F、N、TIL和T(p < 0.05)。TIL为复发抑制因素,其他为复发因素。关于β值的变化,N和NG随时间下降,而F则相反随时间上升。这意味着N和NG主要参与早期复发,F主要参与延迟复发。TIL仅在2年后显示出显著的复发抑制作用。这些结果表明,预后因素对复发的影响随时间改变,即具有明显的时间依赖性。

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