Schönborn I, Minguillon C, Lichtenegger W, Zschiesche W, Spitzer E
Frauenklinik Universtätsklinikum Rudolf Virchow, Standort Charlottenburg, Freie Universitt Berlin.
Geburtshilfe Frauenheilkd. 1995 Oct;55(10):566-71. doi: 10.1055/s-2007-1023525.
In 216 breast cancer patients, the prognostic value of current biological factors (c-erbB-2, EGF-receptor, p53, PCNA-proliferative fraction) was compared with that of conventionally histomorphologic features (histologic type, histologic grade, tumour size, hormonal receptor status). After a 66(6 - 109) months' median follow-up survival was significantly correlated with histological grade (p = 0.014) and PCNA-proliferative activity (p = 0.015). The prognostic influence of oestrogen receptor (ER)- and progesteron receptor (PR-)status achieved borderline significance (ER/p = 0.07; PR/p = 0.05). Neither c-erbB-2, EGF-R, p53 nor any of the other factors showed any correlation to survival. In the multivariate analysis, histological grade was revealed as the only independent prognostic factor. The prognostic value of PCNA was second to histological grade and if grade was excluded from the analysis, PCNA-expression became the only independent factor. Thus, in individual cases the PCNA-proliferative fraction could help the clinician to decide on the therapy.
在216例乳腺癌患者中,对当前生物因子(c-erbB-2、表皮生长因子受体、p53、增殖细胞核抗原增殖分数)的预后价值与传统组织形态学特征(组织学类型、组织学分级、肿瘤大小、激素受体状态)的预后价值进行了比较。经过66(6 - 109)个月的中位随访,生存率与组织学分级(p = 0.014)和增殖细胞核抗原增殖活性(p = 0.015)显著相关。雌激素受体(ER)和孕激素受体(PR)状态的预后影响达到临界显著性(ER/p = 0.07;PR/p = 0.05)。c-erbB-2、表皮生长因子受体、p53以及其他任何因素均未显示与生存率有任何相关性。在多变量分析中,组织学分级被揭示为唯一的独立预后因素。增殖细胞核抗原的预后价值仅次于组织学分级,若在分析中排除分级因素,增殖细胞核抗原表达则成为唯一的独立因素。因此,在个别病例中,增殖细胞核抗原增殖分数可为临床医生的治疗决策提供帮助。