Nazeer T, Ballouk F, Malfetano J H, Figge H, Ambros R A
Department of Pathology, Albany Medical College, New York 12208, USA.
Am J Obstet Gynecol. 1995 Dec;173(6):1829-34. doi: 10.1016/0002-9378(95)90436-0.
We previously described vascular invasion-associated changes, defined as the presence of vascular invasion or perivascular lymphocytic infiltrates, as key prognostic indicators in stage I endometrioid carcinoma. The current study was undertaken to examine the prognostic value of HER-2/neu expression in relation to other factors, including vascular invasion-associated changes, in surgical stage I endometrioid carcinoma.
Seventy-one patients with surgical stage I endometrioid carcinoma treated by hysterectomy and followed up were randomly chosen for retrospective analysis of prognostic indicators including standard clincopathologic features, deoxyribonucleic acid ploidy, and HER-2/neu expression. The latter was examined by an objective computerized quantitative immunohistochemical system.
By univariate analysis many factors were found to correlate with outcome, including age, tumor grade, depth of invasion, ploidy, HER-2/neu expression, and vascular invasion-associated changes. By multivariate analysis only vascular invasion-associated changes, aneuploidy, and HER-2/neu overexpression were found to independently correlate with survival. Stratification of patients on the basis of these three features revealed survival rates of 100%, 92%, and 60% when none, one, and two or three features were present, respectively.
This study suggests that HER-2/neu expression correlated with outcome independent of other factors in endometrial carcinoma and may aid in estimating prognosis. The prognostic value of HER-2/neu overexpression independent of vascular invasion suggests that this factor may operate by increasing the ability of tumor cells to grow at a distal site once vascular invasion occurs.
我们之前将血管侵犯相关改变（定义为存在血管侵犯或血管周围淋巴细胞浸润）描述为Ⅰ期子宫内膜样癌的关键预后指标。本研究旨在探讨HER-2/neu表达在手术Ⅰ期子宫内膜样癌中的预后价值，及其与包括血管侵犯相关改变在内的其他因素的关系。
随机选取71例接受子宫切除术并进行随访的手术Ⅰ期子宫内膜样癌患者，对包括标准临床病理特征、脱氧核糖核酸倍体和HER-2/neu表达在内的预后指标进行回顾性分析。后者通过客观的计算机定量免疫组织化学系统进行检测。
单因素分析发现许多因素与预后相关，包括年龄、肿瘤分级、浸润深度、倍体、HER-2/neu表达和血管侵犯相关改变。多因素分析发现，只有血管侵犯相关改变、非整倍体和HER-2/neu过表达与生存独立相关。根据这三个特征对患者进行分层显示，当不存在、存在一个以及存在两个或三个特征时，生存率分别为100%、92%和60%。
本研究表明，HER-2/neu表达在子宫内膜癌中与预后相关，且独立于其他因素，可能有助于估计预后。HER-2/neu过表达独立于血管侵犯的预后价值表明，该因素可能通过增加肿瘤细胞在血管侵犯发生后在远处部位生长的能力发挥作用。
