Konski A, Domenico D, Tyrkus M, Irving D, Neisler J, Phibbs G, Zeidner S, Eggleston W
Department of Radiation Oncology, Toledo Hospital, OH 43606, USA.
Int J Radiat Oncol Biol Phys. 1996 Jul 15;35(5):935-40. doi: 10.1016/0360-3016(96)00189-7.
To evaluate and correlate the expression of pathologic characteristics, flow cytometric DNA content analysis, and estrogen and progesterone receptor levels with survival in patients with surgical Stage I endometrial carcinoma.
Hospital tumor registry records were surveyed, and this identified 232 patients diagnosed with endometrial adenocarcinoma between July 1, 1989, and December 30, 1993. DNA content analysis was performed on either paraffin-embedded or fresh tissue samples. Survival was calculated from the date of diagnosis by the Kaplan-Meier method. Postoperative irradiation (whole pelvis external beam therapy and low dose rate vaginal cuff brachytherapy) was delivered to patients felt to be at high risk for failure.
One hundred seventy-one patients had Stage I tumors and were available for analysis. Patients with Stage 1C tumors had a statistically significant lower survival rate compared to patients with Stages IA or IB (p = 0.03 and p < 0.01, respectively). Patients with DNA content diploid tumors had a slightly increased (but nonsignificantly so) survival compared to patients with non-DNA content diploid tumors (p = 0.12). Logistic regression analysis failed to identify an independent prognostic factor that could predict for disease specific survival in patients with Stage I cancers.
Logistic regression analysis did not identify a single independent prognostic factor in patients with Stage I tumors. Pathologic characteristics reported to predict survival advantage correlated with pathologic stage. Additional translational research is needed to identify molecular characteristics of tumors that may indicate more aggressive treatment for patients at high risk for recurrence.
评估手术分期为I期的子宫内膜癌患者的病理特征、流式细胞术DNA含量分析、雌激素和孕激素受体水平的表达，并将其与生存率进行关联分析。
对医院肿瘤登记记录进行了调查，共确定了1989年7月1日至1993年12月30日期间诊断为子宫内膜腺癌的232例患者。对石蜡包埋或新鲜组织样本进行DNA含量分析。采用Kaplan-Meier法从诊断日期开始计算生存率。对被认为有高失败风险的患者进行术后放疗（全盆腔外照射和低剂量率阴道袖口近距离放疗）。
171例患者为I期肿瘤，可供分析。与IA期或IB期患者相比，1C期肿瘤患者的生存率在统计学上显著较低（分别为p = 0.03和p < 0.01）。与非DNA含量二倍体肿瘤患者相比，DNA含量二倍体肿瘤患者的生存率略有提高（但无统计学意义，p = 0.12）。逻辑回归分析未能确定一个能够预测I期癌症患者疾病特异性生存的独立预后因素。
逻辑回归分析未在I期肿瘤患者中确定单一的独立预后因素。据报道可预测生存优势的病理特征与病理分期相关。需要进一步的转化研究来确定肿瘤的分子特征，这些特征可能表明对复发高风险患者需要更积极的治疗。
