Head J F, Wang F, Elliott R L
Elliott Mastology Center, Baton Rouge, Louisiana 70816.
Ann N Y Acad Sci. 1993 Nov 30;698:153-8. doi: 10.1111/j.1749-6632.1993.tb17203.x.
Our recent retrospective analysis of the clinical records of patients who had breast thermography demonstrated that an abnormal thermogram was associated with an increased risk of breast cancer and a poorer prognosis for the breast cancer patient. This study included 100 normal patients, 100 living cancer patients, and 126 deceased cancer patients. Abnormal thermograms included asymmetric focal hot spots, areolar and periareolar heat, diffuse global heat, vessel discrepancy, or thermographic edge sign. Incidence and prognosis were directly related to thermographic results: only 28% of the noncancer patients had an abnormal thermogram, compared to 65% of living cancer patients and 88% of deceased cancer patients. Further studies were undertaken to determine if thermography is an independent prognostic indicator. Comparison to the components of the TNM classification system showed that only clinical size was significantly larger (p = 0.006) in patients with abnormal thermograms. Age, menopausal status, and location of tumor (left or right breast) were not related to thermographic results. Progesterone and estrogen receptor status was determined by both the cytosol-DCC and immunocytochemical methods, and neither receptor status showed any clear relationship to the thermographic results. Prognostic indicators that are known to be related to tumor growth rate were then compared to thermographic results. The concentration of ferritin in the tumor was significantly higher (p = 0.021) in tumors from patients with abnormal thermograms (1512 +/- 2027, n = 50) compared to tumors from patients with normal thermograms (762 +/- 620, n = 21). Both the proportion of cells in DNA synthesis (S-phase) and proliferating (S-phase plus G2M-phase, proliferative index) were significantly higher in patients with abnormal thermograms. The expression of the proliferation-associated tumor antigen Ki-67 was also associated with an abnormal thermogram. The strong relationships of thermographic results with these three growth rate-related prognostic indicators suggest that breast cancer patients with abnormal thermograms have faster-growing tumors that are more likely to have metastasized and to recur with a shorter disease-free interval.
我们最近对接受过乳房热成像检查的患者临床记录进行的回顾性分析表明，热成像异常与乳腺癌风险增加以及乳腺癌患者预后较差相关。该研究纳入了100名正常患者、100名存活的癌症患者和126名已故的癌症患者。异常热成像包括不对称局灶性热点、乳晕及乳晕周围发热、弥漫性整体发热、血管差异或热成像边缘征。发病率和预后与热成像结果直接相关：非癌症患者中只有28%的热成像异常，而存活的癌症患者中这一比例为65%，已故的癌症患者中为88%。我们进一步开展研究以确定热成像是否为独立的预后指标。与TNM分类系统的各组成部分进行比较显示，热成像异常的患者仅临床肿瘤大小显著更大（p = 0.006）。年龄、绝经状态以及肿瘤位置（左乳或右乳）与热成像结果无关。通过胞液-DCC法和免疫细胞化学法测定孕激素和雌激素受体状态，两种受体状态均与热成像结果无明显关联。随后将已知与肿瘤生长速率相关的预后指标与热成像结果进行比较。热成像异常患者的肿瘤中（1512 +/- 2027，n = 50）铁蛋白浓度显著高于热成像正常患者的肿瘤（762 +/- 620，n = 21）（p = 0.021）。热成像异常患者中处于DNA合成期（S期）的细胞比例以及增殖期（S期加G2M期，增殖指数）均显著更高。增殖相关肿瘤抗原Ki-67的表达也与热成像异常相关。热成像结果与这三个与生长速率相关的预后指标之间的密切关系表明，热成像异常的乳腺癌患者肿瘤生长更快，更有可能发生转移且无病间期更短而复发。
