Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer
Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer
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DOI：
10.1007/s10549-009-0442-x
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发表时间：
2010-05-01
影响因子：
3.8
通讯作者：
Baak, Jan P. A.
中科院分区：
文献类型：
--
作者：
Gudlaugsson, Einar;Skaland, Ivar;Baak, Jan P. A.
淋巴结阴性（LNneg）浸润性小叶癌（ILC）预后因素的评估。对121例LNneg ILC（中位随访119个月，范围19-181）的增殖和其他促增殖因子进行前瞻性分析，未进行辅助化疗。按照WHO-2003标准评估ILC亚型。免疫组织化学方法采用E-钙粘蛋白和雌激素受体。中位随访时间为83个月（范围19-181），121例ILC患者中有30例（25%）发生远处转移，27例（22%）死亡。与其他ILC相比，被分类为实性/多形性小叶的病例中没有E-cadherin或雌激素受体阳性。实性/肺泡型ILC（n = 17）的生存率（50%）低于其他ILC（n = 104; 83%，P < 0.0001）。有丝分裂活性指数（MAI）（但不是核分级或小管形成）是预后的阈值0-5与> 5（=MAI-5）（对比MAI < 10与一般乳腺癌的千分之一; 85和54%的生存率，P < 0.0001）。在多因素分析中，只有亚型和MAI具有独立的预后价值，而其他特征均无独立的预后价值。在淋巴结阴性的浸润性小叶癌中，组织学亚型和MAI具有独立的预后价值。
Evaluation of prognostic factors in lymph node negative (LNneg) invasive lobular cancers (ILCs). Prospective analysis of proliferation and other prognosticators in 121 LNneg ILCs (119 months median follow-up, range 19-181), without adjuvant chemotherapy. ILC subtype was assessed in accordance with WHO-2003 criteria. Immunohistochemical E-cadherin and estrogen receptor were used. With a median follow up time of 83 months (range 19-181), 30 of the 121 (25%) ILC patients developed distant metastases and 27 (22%) died. None of the cases classified as solid/pleomorphic lobular were E-cadherin or estrogen receptor positive, contrasting the other ILCs. The solid/alveolar ILCs (n = 17) had a worse survival (50%) than the other ILCs (n = 104; 83%, P < 0.0001). Mitotic activity index (MAI) (but not nuclear grade or tubule formation) was prognostic with a threshold 0-5 versus > 5 (=MAI-5) (contrasting MAI < 10 vs. a parts per thousand yen10 in breast cancers in general; 85 and 54% survival, P < 0.0001). In multivariate analysis only subtype and MAI but none of the other characteristics had independent prognostic value. Histologic subtype and MAI have independent prognostic value in node negative invasive lobular cancers.