S期分数在头颈部鳞状细胞癌和腋窝淋巴结阴性乳腺癌中的预后价值

Prognostic value of S-phase fraction in head and neck squamous cell carcinomas and nodal negative breast carcinomas.

作者信息

Fietkau R, Iro H, Tulusan A H, Dressel V, Altendorf-Hofmann A, Sauer R

机构信息

Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.

出版信息

Strahlenther Onkol. 1994 Jan;170(1):13-24.

PMID:8303573

Abstract

PURPOSE

The prognostic value of proliferative activity (percentage of S-phase cells = SPF) was determined in head and neck and nodal negative breast carcinomas and correlated with treatment outcome and analysis of recurrence.

METHODS AND MATERIAL

SPF of 171 primary squamous cell carcinomas of the head and neck and 183 nodal negative breast carcinomas was determined by one-dimensional flow cytometry.

RESULTS

For the whole population of head and neck carcinomas slowly proliferating tumors (SPF < median) had a better five-year survival rate (28%) than fast proliferating tumors (S-phase > median; 20% p < 0.05). Failure analysis revealed that the better survival of slowly proliferating tumors was due to the higher loco-regional control rate (62%) compared to fast proliferating tumors (43%; p < 0.05). Stepwise multivariate analysis revealed treatment modality (p = 0.107), SPF (p = 0.026) and UICC stage (p = 0.044) as independent prognostic factors for loco-regional recurrences and SPF (p = 0.0143) for three-year overall survival. In nodal negative breast cancer slowly proliferating tumors (SPF < median) had a better NED survival (92%) compared to fast proliferating tumors (SPF > median; NED survival 63%). The analysis of recurrence revealed a higher rate of distant metastases (15.7%) and of loco-regional recurrences (21%) for fast proliferating tumors as compared to slowly proliferating tumors (distant metastases: 1.1%; loco-regional recurrences 4.5%). Stepwise multivariate analysis showed that SPF (p = 0.001) was the only independent prognostic factor for NED survival; grading (p = 0.022), age (p = 0.003) and SPF (p = 0.007) for freedom from distant metastases; SPF (p = 0.0039), grading (p = 0.0956) and method of surgical treatment (p = 0.0715) for loco-regional recurrences.

CONCLUSIONS

SPF has a relevant prognostic power for squamous cell head and neck cancer and nodal negative breast cancer.

摘要

目的

确定增殖活性（S期细胞百分比=SPF）在头颈部癌和腋窝淋巴结阴性乳腺癌中的预后价值，并将其与治疗结果及复发分析相关联。

方法与材料

通过一维流式细胞术测定171例头颈部原发性鳞状细胞癌和183例腋窝淋巴结阴性乳腺癌的SPF。

结果

对于头颈部癌的总体人群，增殖缓慢的肿瘤（SPF<中位数）的五年生存率（28%）高于增殖快速的肿瘤（S期>中位数；20%，p<0.05）。失败分析显示，增殖缓慢的肿瘤生存率更高是由于其局部区域控制率（62%）高于增殖快速的肿瘤（43%；p<0.05）。逐步多因素分析显示，治疗方式（p=0.107）、SPF（p=0.026）和国际抗癌联盟（UICC）分期（p=0.044）是局部区域复发的独立预后因素，而SPF（p=0.0143）是三年总生存率的独立预后因素。在腋窝淋巴结阴性乳腺癌中，增殖缓慢的肿瘤（SPF<中位数）的无病生存率（92%）高于增殖快速的肿瘤（SPF>中位数；无病生存率63%）。复发分析显示，与增殖缓慢的肿瘤相比，增殖快速的肿瘤远处转移率（15.7%）和局部区域复发率（21%）更高（远处转移：1.1%；局部区域复发4.5%）。逐步多因素分析表明，SPF（p=0.001）是无病生存率的唯一独立预后因素；分级（p=0.022）、年龄（p=0.003）和SPF（p=0.007）是无远处转移的独立预后因素；SPF（p=0.0039）、分级（p=0.0956）和手术治疗方式（p=0.0715）是局部区域复发的独立预后因素。