A simple index to predict prognosis independent of axillary node information in breast cancer.

A simple index to predict prognosis independent of axillary node information in breast cancer.
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一个独立于乳腺癌腋窝淋巴结信息预测预后的简单指标。

DOI：
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发表时间：
1997
期刊：
Australian and New Zealand Journal of Surgery
影响因子：
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通讯作者：
Anthony S
Anthony S
中科院分区：
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文献类型：
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作者：
Ram Seshadri;D. Horsfall;Kieran McCaul;Anthony S

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背景 由于乳腺癌的病程通常是不可预测的，因此我们希望开发一种仅使用原发肿瘤特征来预测预后的模型。 方法 确定了一些肿瘤特征，在中位随访 65 个月后，多变量分析确定肿瘤大小和分级、雌激素受体浓度、腋窝淋巴结转移和肿瘤细胞增殖分数（MIB-1 计数）与乳腺癌复发和死亡风险增加独立相关。仅使用肿瘤大小和等级、雌激素受体浓度和 MIB-1 计数构建预后模型。肿瘤大小 > 20 mm、肿瘤等级 2 或 3、雌激素受体浓度 < 10 fmol/mg 胞质蛋白和 MIB-1 计数 > 9% 的每项得分为 1。通过为每位患者分配 0、1、2、3 或 4 的综合评分而建立的 5 个组，分析了它们与无病生存率和总生存率的关联。 结果 该初步模型预测五组的 5 年生存率分别为 97%、91%、85%、68% 和 50%。通过从分析中排除肿瘤等级，该模型得到了进一步简化。修订后的模型确定了四个风险组，预测 5 年生存率分别为 91%、86%、66% 和 52%。该模型（阿德莱德预后指数）还能够识别淋巴结阴性和淋巴结阳性患者的四个风险组。 结论 即使在缺乏腋窝淋巴结信息的情况下，阿德莱德预后指数也可用于预测预后。
BACKGROUND Since the course of breast cancer is often unpredictable, we wished to develop a model using characteristics of the primary tumour alone to predict prognosis. METHODS Several tumour features were determined, and after a median follow-up duration of 65 months, multivariate analysis identified tumour size and grade, oestrogen receptor concentration, axillary lymph node metastasis and tumour cell proliferation fraction (MIB-1 count) as being independently associated with increases in risk for both relapse and death from breast cancer. A prognostic model was constructed using tumour size and grade, oestrogen receptor concentration and MIB-1 count only. A score of 1 for each was given to tumour size > 20 mm, tumour grade 2 or 3, oestrogen receptor concentration < 10 fmol/mg cytosol protein and MIB-1 count > 9%. Five groups established by assigning a combined score of 0, 1, 2, 3 or 4 for each patient were analysed for their associations with disease-free and overall survivals. RESULTS This preliminary model predicted 5-year survival rates of 97, 91, 85, 68 and 50% for the five groups. The model was further simplified by excluding tumour grade from the analysis. The revised model identified four risk groups with predicted 5-year survival rates of 91, 86, 66 and 52%. This model, the Adelaide prognostic index, was also able to identify four risk groups in both node-negative and node-positive patients. CONCLUSIONS The Adelaide prognostic index can be used to predict prognosis even in the absence of axillary lymph node information.