Morphologic complexity of epithelial architecture for predicting invasive breast cancer survival.
Morphologic complexity of epithelial architecture for predicting invasive breast cancer survival.
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上皮结构的形态复杂性用于预测侵入性乳腺癌存活。
DOI：
10.1186/1479-5876-8-140
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发表时间：
2010-12-31
影响因子：
7.4
通讯作者：
Magliocco AM
中科院分区：
文献类型：
--
作者：
Tambasco M;Eliasziw M;Magliocco AM
辅助化疗的最佳患者选择的精确标准仍然存在争议，包括主观成分，如肿瘤形态学（病理分级）。有必要用客观测量取代主观标准，以改善风险评估和治疗决策。我们评估了分形维数（一种形态复杂性的客观度量）对乳腺浸润性导管癌的预后价值。我们应用分形分析，泛细胞角蛋白染色的组织芯片（TMA）核心来自379例患者。患者根据低（<1.56，N = 141）、中等（1.56-1.75，N = 148）和高（>1.75，N = 90）分形维数分类。考克斯比例风险回归用于评估疾病特异性和总生存率与分形维数、肿瘤大小、分级、淋巴结状态、雌激素受体状态和HER-2/neu状态之间的关系。具有较高分形分数的患者具有显著较低的疾病特异性10年生存率（高、中和低分形维数分别为25.0%、56.4%和69.4%，p < 0.001）。总体10年生存率显示出类似的相关性。分形维数、淋巴结状态和分级是唯一显著（P < 0.05）的疾病特异性和总生存率的独立预测因子。在所有的预测因子中，疾病特异性生存的分维风险比为2.6（95%可信区间（CI）= 1.4，4.8; P = 0.002），仅次于略高的淋巴结状态风险比3.1（95% CI = 1.9，5.1; P < 0.001）。对于总生存期，分形维数的危险比最高，为2.7（95% CI = 1.6，4.7; P < 0.001）。分裂样本交叉验证分析表明，这些结果是普遍的。除淋巴结状态外，通过分形维数定量测量的乳腺上皮的形态复杂性与疾病特异性和总体生存率的相关性比标准预测因子更强且更显著。
Precise criteria for optimal patient selection for adjuvant chemotherapy remain controversial and include subjective components such as tumour morphometry (pathological grade). There is a need to replace subjective criteria with objective measurements to improve risk assessment and therapeutic decisions. We assessed the prognostic value of fractal dimension (an objective measure of morphologic complexity) for invasive ductal carcinoma of the breast. We applied fractal analysis to pan-cytokeratin stained tissue microarray (TMA) cores derived from 379 patients. Patients were categorized according to low (<1.56, N = 141), intermediate (1.56-1.75, N = 148), and high (>1.75, N = 90) fractal dimension. Cox proportional-hazards regression was used to assess the relationship between disease-specific and overall survival and fractal dimension, tumour size, grade, nodal status, estrogen receptor status, and HER-2/neu status. Patients with higher fractal score had significantly lower disease-specific 10-year survival (25.0%, 56.4%, and 69.4% for high, intermediate, and low fractal dimension, respectively, p < 0.001). Overall 10-year survival showed a similar association. Fractal dimension, nodal status, and grade were the only significant (P < 0.05) independent predictors for both disease-specific and overall survival. Among all of the prognosticators, the fractal dimension hazard ratio for disease-specific survival, 2.6 (95% confidence interval (CI) = 1.4,4.8; P = 0.002), was second only to the slightly higher hazard ratio of 3.1 (95% CI = 1.9,5.1; P < 0.001) for nodal status. As for overall survival, fractal dimension had the highest hazard ratio, 2.7 (95% CI = 1.6,4.7); P < 0.001). Split-sample cross-validation analysis suggests these results are generalizable. Except for nodal status, morphologic complexity of breast epithelium as measured quantitatively by fractal dimension was more strongly and significantly associated with disease-specific and overall survival than standard prognosticators.
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影响因子：
5.8
作者：
Cianfrocca, M;Goldstein, LJ
通讯作者：
Goldstein, LJ
影响因子：
5.8
作者：
Cianfrocca, M;Gradishar, WJ
通讯作者：
Gradishar, WJ
影响因子：
3.3
作者：
ROBBINS, P;PINDER, S;ELSTON, C
通讯作者：
ELSTON, C
DOI：
10.1002/ssu.2980050206
发表时间：
1989-01-01
期刊：
SEMINARS IN SURGICAL ONCOLOGY
影响因子：
--
作者：
SAEZ, RA;MCGUIRE, WL;CLARK, GM
通讯作者：
CLARK, GM
影响因子：
7.5
作者：
Meyer, JS;Alvarez, C;Parwaresch, R
通讯作者：
Parwaresch, R