RELATIVE WORTH OF ESTROGEN OR PROGESTERONE-RECEPTOR AND PATHOLOGIC CHARACTERISTICS OF DIFFERENTIATION AS INDICATORS OF PROGNOSIS IN NODE NEGATIVE BREAST-CANCER PATIENTS - FINDINGS FROM NATIONAL SURGICAL ADJUVANT BREAST AND BOWEL PROJECT PROTOCOL B-06
RELATIVE WORTH OF ESTROGEN OR PROGESTERONE-RECEPTOR AND PATHOLOGIC CHARACTERISTICS OF DIFFERENTIATION AS INDICATORS OF PROGNOSIS IN NODE NEGATIVE BREAST-CANCER PATIENTS - FINDINGS FROM NATIONAL SURGICAL ADJUVANT BREAST AND BOWEL PROJECT PROTOCOL B-06
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DOI：
10.1200/jco.1988.6.7.1076
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发表时间：
1988-07-01
影响因子：
45.3
通讯作者：
CAPLAN, R
中科院分区：
文献类型：
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作者：
FISHER, B;REDMOND, C;CAPLAN, R
本研究将1，157例组织学淋巴结阴性乳腺癌患者的无病生存期（DFS）、无远处转移生存期（DDFS）和生存期（S）与其肿瘤的雌激素和/或孕激素受体（ER、PR）以及细胞核或组织学分级（NG、HG）相关联。均行手术治疗，未行全身辅助治疗。ER阳性肿瘤患者的DFS、DDFS和S显著高于ER阴性肿瘤患者（P = 0.005，0.004，<0.001），但5年随访后差异的幅度很小（DFS和DDFS均为8%，S为10%）。这种程度的差异不足以明确区分哪些患者应该接受或不应该接受全身治疗。与ER一样，结果差异有利于PR阳性肿瘤，但仅在S中差异显著（5年时为8%; P = 0.002）。当与ER结合时，PR在结局预测中没有独立贡献。回归分析表明，NG是最重要的单一指标的结果。ER或PR阳性者的预后与ER或PR阳性者相当或更好。这一发现似乎与肿瘤大小有关，因为具有未知受体的肿瘤比例较高，
This study correlates the disease-free survival (DFS), distant disease-free survival (DDFS), and survival (S) of 1,157 histologically node negative breast cancer patients with the estrogen and/or progesterone receptor (ER, PR) and with the nuclear or histologic grade (NG, HG) of their tumors. All were treated by operation without systemic adjuvant therapy. The DFS, DDFS, and S were significantly greater (P = .005, .004, < .001) in patients with ER positive than ER negative tumors but the magnitude of the differences after 5 years of follow-up was slight (8% in both DFS and DDFS and 10% in S). Differences of that magnitude are insufficient to discriminate clearly between patients who should or should not receive systemic therapy. As with ER, there were outcome differences in favor of PR positive tumors but only in S was the difference significant (8% at 5 years; P = .002). When combined with ER, PR made no independent contribution in the outcome prediction. Regression analysis indicated that NG was the most important single marker of outcome. The prognosis of women with unknown ER or PR was equivalent to or better than that in those with ER or PR positive tumors. This finding seems to be related to tumor size in that a higher proportion of tumors with unknown receptors were