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孕激素受体水平可独立预测子宫内膜腺癌的生存率。

Progesterone receptor levels independently predict survival in endometrial adenocarcinoma.

作者信息

Nyholm H C, Christensen I J, Nielsen A L

机构信息

Department of Gynecology and Obstetrics, University of Copenhagen, Hvidovre Hospital, Denmark.

出版信息

Gynecol Oncol. 1995 Dec;59(3):347-51. doi: 10.1006/gyno.1995.9964.

Abstract

Estrogen receptor (ER) and progesterone receptor (PR) contents were determined by biochemical (dextran charcoal-coated (DCC) assay) and immunohistochemical (ICA) methods in biopsies from 145 primary endometrial adenocarcinomas and those with eligible receptor measurements were analyzed with respect to correlations to cancer-specific survival in a multivariate analysis including histopathological characteristics. Median patient follow-up time was 67 months with 18 cancer deaths. The PR-DCC and ER-DCC values were dichotomized according to levels previously found by us to correspond to the best agreement between receptor status as determined by the DCC and ICA methods (130 fmol/mg cytosol protein for ER, 114 fmol/mg for PR). Using these thresholds, we found by multivariate analysis that "high" PR-DCC levels (> 114 fmol/mg) correlated significantly (P = 0.004) with survival, independent of stage risk group (Ia + b vs Ic-IV). Patient age and histologic grade were prognostic factors in a univariate setting, but these parameters were eliminated in the multivariate model. While the PR-ICA scores also correlated significantly and independently with survival, the predictive effect of PR-ICA positivity alone could not be statistically evaluated due to the number of cases with eligible ICA values. However, we suggest that owing to a close correlation between DCC and ICA results, PR-ICA status may provide significant prognostic information when DCC measurements are not available.

摘要

采用生化方法(葡聚糖包被活性炭法,DCC法)和免疫组化方法(ICA法),对145例原发性子宫内膜腺癌活检组织中的雌激素受体(ER)和孕激素受体(PR)含量进行测定,并在一项包括组织病理学特征的多因素分析中,对有合格受体测量值的病例分析其与癌症特异性生存的相关性。患者中位随访时间为67个月,有18例癌症死亡。根据我们之前发现的DCC法和ICA法测定的受体状态之间最佳一致性的水平,将PR-DCC和ER-DCC值进行二分法划分(ER为130 fmol/mg胞浆蛋白,PR为114 fmol/mg)。采用这些阈值,我们通过多因素分析发现,“高”PR-DCC水平(>114 fmol/mg)与生存显著相关(P = 0.004),独立于分期风险组(Ia + b期与Ic-IV期)。患者年龄和组织学分级在单因素分析中是预后因素,但在多因素模型中这些参数被排除。虽然PR-ICA评分也与生存显著且独立相关,但由于有合格ICA值的病例数量,单独PR-ICA阳性的预测效果无法进行统计学评估。然而,我们认为,由于DCC和ICA结果之间密切相关,当无法进行DCC测量时,PR-ICA状态可能提供重要的预后信息。

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