Asagoe T, Hanatani Y, Doi M, Miyoshi H, Hasumi T, Nagaoka N, Hanashi T, Kodaira S
The 1st Department of Surgery, Teikyo University School of Medicine, Japan.
Gan To Kagaku Ryoho. 1996 Feb;23(3):311-6.
A clinicopathological study on prognosis has been carried out in 233 breast cancer patients with more than twenty inspected nodes and without lymph node metastasis. Multivariate analysis of clinicopathological findings in node-negative breast cancers showed that the best combination of clinical features predicting prognosis were age, menstruation status, tumor location and tumor diameter; and from 11 pathological features, three factors (histological type, histological grade and the grade of tumor infiltrating lymphocytes) were selected under condition of p<0.05. With solid-tubular carcinoma, histological grade III and negative tumor infiltrating lymphocytes as the 3 poor prognostic factors, node-negative breast cancers were classified. The recurrence rates of subgroups with the number of 3, 2, 1 and 0 were 28%, 16%, 7% and 0%, respectively. We conclude that the grade of tumor infiltrating lymphocytes is especially significant as the prognostic factor in node-negative breast cancers, and that postoperative adjuvant chemoendocrine therapy must be performed for patients with node-negative breast cancer with more than two poor prognostic pathological factors.
对233例有20个以上检查淋巴结且无淋巴结转移的乳腺癌患者进行了预后的临床病理研究。对淋巴结阴性乳腺癌的临床病理结果进行多因素分析显示,预测预后的最佳临床特征组合为年龄、月经状况、肿瘤位置和肿瘤直径;在11项病理特征中,在p<0.05的条件下选择了3个因素(组织学类型、组织学分级和肿瘤浸润淋巴细胞分级)。以实性-管状癌、组织学III级和肿瘤浸润淋巴细胞阴性作为3个不良预后因素,对淋巴结阴性乳腺癌进行分类。3个、2个、1个和0个不良预后因素亚组的复发率分别为28%、16%、7%和0%。我们得出结论,肿瘤浸润淋巴细胞分级作为淋巴结阴性乳腺癌的预后因素尤为重要,并且对于具有两个以上不良预后病理因素的淋巴结阴性乳腺癌患者必须进行术后辅助化疗和内分泌治疗。