Cuzick J, Holland R, Barth V, Davies R, Faupel M, Fentiman I, Frischbier H J, LaMarque J L, Merson M, Sacchini V, Vanel D, Veronesi U
Imperial Cancer Research Fund, London, UK.
Lancet. 1998 Aug 1;352(9125):359-63. doi: 10.1016/s0140-6736(97)10002-2.
Proliferative changes in breast epithelium are an intrinsic aspect in the development of breast cancer, and result in regions of epithelial electrical depolarisation within the breast parenchyma, which can extend to the skin surface. Diagnostic information might be obtained from a non-imaging and non-invasive test based on skin-surface electropotentials.
In 661 women, scheduled for open biopsy at eight European centres, we studied whether measurements of breast electrical activity with surface sensors could distinguish benign from malignant breast disease. A depolarisation index was developed.
We found a highly significant trend of progressive electrical changes according to the proliferative characteristics of the biopsied tissue. Discriminatory information was obtained in both premenopausal and postmenopausal women, and the index was not related to age. The best test performances were for women with palpable lesions. The median index was 0.398 for non-proliferative benign lesions, 0.531 for proliferative benign lesions, and 0.644 for cancer (ductal carcinoma-in-situ and invasive). A specificity of 55% was obtained at 90% sensitivity for women with palpable lesions when a discriminant based on age and the depolarisation index was used.
This new modality may have diagnostic value, especially in reducing the number of unnecessary diagnostic tests among women with inconclusive findings on physical examination. Understanding and control of the biological variability of these electrical phenomena will be important in the improvement of this test. Studies in populations with a lower cancer prevalence are needed to assess further the diagnostic value of this approach.
乳腺上皮的增殖性变化是乳腺癌发生发展的内在因素,可导致乳腺实质内出现上皮性电去极化区域,并可延伸至皮肤表面。基于皮肤表面电势的非成像、非侵入性检测可能获取诊断信息。
在欧洲八个中心计划进行开放性活检的661名女性中,我们研究了使用表面传感器测量乳腺电活动能否区分乳腺良性疾病和恶性疾病。制定了一个去极化指数。
根据活检组织的增殖特征,我们发现电变化存在高度显著的渐进趋势。绝经前和绝经后女性均获得了鉴别信息,且该指数与年龄无关。对可触及病变的女性检测性能最佳。非增殖性良性病变的去极化指数中位数为0.398,增殖性良性病变为0.531,癌症(原位导管癌和浸润性癌)为0.644。当使用基于年龄和去极化指数的判别方法时,对可触及病变的女性,在90%灵敏度下特异性为55%。
这种新方法可能具有诊断价值,尤其是在减少体格检查结果不明确的女性中不必要的诊断检查数量方面。了解和控制这些电现象的生物学变异性对改进该检测至关重要。需要在癌症患病率较低的人群中进行研究,以进一步评估这种方法的诊断价值。