Wyss-Desserich M T, Caduff-Joos R, Wyss P, Rageth C, Wight E, Unger C, Walt H, Haller U
Department of Gynecology and Obstetrics, University Hospital of Zurich, Switzerland.
Breast Cancer Res Treat. 1997 Feb;42(3):253-63. doi: 10.1023/a:1005729304068.
The management of premenopausal node-negative breast cancer patients is discussed controversially. Accurate cellular as well as biochemical markers are essential for this cancer group to identify high risk patients needing adjuvant chemotherapy. In the present study, flow cytometric DNA analysis (DNA-ploidy status, DNA-index, S-phase fraction, S+(G2+M)-phase fraction) and clinico-pathological variables (clinical stage, tumor size, receptor status, age, histological type and grade) as prognostic factors were determined on paraffin-embedded tumors to predict overall survival (OS) and disease-free survival (DFS). Median observation time was 6.1 years (n = 57). S+(G2+M)-phase fraction was the only flow cytometric DNA predictor of overall survival in the univariate analysis (log-rank test): As compared to the patients with lower S+(G2+M)-phase fraction (< or = 9.3%), patients with S+(G2+M)-phase fraction greater than 9.3% had shorter survival (P = 0.039). Of all the clinico-pathological parameters analyzed (univariate analysis), the survival time was found to be longer when estrogen- and/or progesterone-receptor status was positive (overall survival: P = 0.039; disease-free survival: P = 0.017) and the histological grade was low (overall survival: I + II vs III: P = 0.024; I vs II vs III: P = 0.046). In the multivariate analysis, receptor status was the strongest predictor for overall and disease-free survival. These results suggest that S+(G2+M)-phase fraction in premenopausal node-negative breast cancer could be an additional valuable prognostic factor to classify high risk breast cancer patients needing adjuvant chemotherapy.
绝经前淋巴结阴性乳腺癌患者的治疗存在争议。对于这一癌症群体而言，准确的细胞及生化标志物对于识别需要辅助化疗的高危患者至关重要。在本研究中，对石蜡包埋肿瘤进行流式细胞术DNA分析（DNA倍体状态、DNA指数、S期分数、S+(G2+M)期分数）以及临床病理变量（临床分期、肿瘤大小、受体状态、年龄、组织学类型和分级）作为预后因素，以预测总生存期（OS）和无病生存期（DFS）。中位观察时间为6.1年（n = 57）。在单变量分析（对数秩检验）中，S+(G2+M)期分数是总生存期的唯一流式细胞术DNA预测指标：与S+(G2+M)期分数较低（≤9.3%）的患者相比，S+(G2+M)期分数大于9.3%的患者生存期较短（P = 0.039）。在所有分析的临床病理参数（单变量分析）中，发现雌激素和/或孕激素受体状态为阳性时生存期较长（总生存期：P = 0.039；无病生存期：P = 0.017），且组织学分级较低时生存期较长（总生存期：I + II期与III期相比：P = 0.024；I期与II期与III期相比：P = 0.046）。在多变量分析中，受体状态是总生存期和无病生存期的最强预测指标。这些结果表明，绝经前淋巴结阴性乳腺癌中的S+(G2+M)期分数可能是用于对需要辅助化疗的高危乳腺癌患者进行分类的另一个有价值的预后因素。
