Batsakis J G, Sneige N, el-Naggar A K
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1993 Mar 15;71(6 Suppl):2151-3. doi: 10.1002/1097-0142(19930315)71:6+<2151::aid-cncr2820711604>3.0.co;2-b.
The advent of therapeutic alternatives for patients with breast cancer has altered their clinical management profoundly. Because of this, the need for reliable prognostic indicators with definable clinical utility has spawned a number of objective evaluations of the neoplasm itself. Flow cytometric analysis of DNA and the cell cycle (S-phase fraction) are two of the objective measurements. Their current status in breast cancer is unclear. In the important category of carcinomas with negative axillary lymph nodes, DNA content (ploidy) information does not add important, independent, or prognostic information. S-phase fraction, in addition to correlating with DNA content and histologic grade, may be an independent factor, but methodologic variables have hampered definite conclusions about its utility. Currently, given the rather consistent absence of correlation between DNA ploidy, S-phase fractions, and nodal metastases, the independent prognostic utility of the two flow cytometric parameters can be questioned. A resolution of their final status in the prognostic hierarchy depends on rigorous adherence to the variables affecting them, i.e., preanalytic, analytic, and postanalytic factors.
乳腺癌患者治疗选择的出现深刻改变了他们的临床管理。因此，对具有明确临床效用的可靠预后指标的需求催生了对肿瘤本身的一些客观评估。DNA和细胞周期的流式细胞术分析（S期分数）是其中两项客观测量方法。它们在乳腺癌中的当前状况尚不清楚。在腋窝淋巴结阴性的重要癌种类别中，DNA含量（倍体）信息并不能增加重要的、独立的或预后信息。S期分数除了与DNA含量和组织学分级相关外，可能是一个独立因素，但方法学变量阻碍了对其效用得出明确结论。目前，鉴于DNA倍体、S期分数与淋巴结转移之间相当一致地缺乏相关性，这两个流式细胞术参数的独立预后效用值得质疑。它们在预后分级中的最终地位的确定取决于严格遵循影响它们的变量，即分析前、分析中和分析后因素。
