COMPARATIVE PATHOLOGY OF BREAST-CANCER IN A RANDOMIZED TRIAL OF SCREENING
COMPARATIVE PATHOLOGY OF BREAST-CANCER IN A RANDOMIZED TRIAL OF SCREENING
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DOI：
10.1038/bjc.1991.251
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发表时间：
1991-07-01
影响因子：
8.8
通讯作者：
FORREST, P
中科院分区：
文献类型：
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作者：
ANDERSON, TJ;LAMB, J;FORREST, P
在爱丁堡随机乳房筛查项目(EBSP)中，截至1988年12月，研究人群中有500名癌症患者被邀请进行筛查，而对照人群中有340名癌症患者被确认患有癌症。两组浸润性癌的大小和阴性淋巴状态特征有显著差异(P<；0.05)。筛查发现的癌症主要是早期癌症，16%的非侵袭性(PTI)和42%的侵袭性I期(PT1结节阴性)，而癌症通常是晚期的(超过PT2)，在无参与者(44%)和对照组(36%)中不能手术。根据浸润性癌的惯常大小范围分组，筛查的淋巴结阳性病例的比例与对照组不同，但筛查的益处并不是恒定的。在患病率筛查和发病率筛查时发现的癌症的比较中，作为与筛查理论的符合性检验，大小和淋巴结状况方面没有明显差异，但肿瘤的组织类型特征具有显著的区分性(P<；0.05)。当使用这些相同的组织学特征来比较存活率时，将浸润性癌分为存活率好和存活率差的两组的能力是显而易见的，与对照组相比，筛查到存活率差的组有显著的改善(P<；0.05)。
In the Edinburgh Randomised Breast Screening Project (EBSP) to December 1988 there were 500 cancers in the study population invited to screening and 340 cancers identified in the control population. The size and negative lymph node status characteristics of invasive cancers from the two populations were significantly different (P < 0.05). The cancers detected by screening were predominantly 'early stage', with 16% noninvasive (PTIS) and 42% invasive stage I (pT1 node negative), whereas cancers were frequently 'late stage' (more than pT2) and inoperable in nonattenders (44%) and controls (36%). Grouped according to customary size ranges of invasive cancers, the proportion of cases lymph node positive differed in those screen detected compared with controls, but the benefit in favour of screen detection was not constant. In comparisons of cancers detected at prevalence and incidence screens, as a test of conformity with screening theory, no significant differences were apparent according to size and lymph node status, yet the characteristics of histological type of cancer discriminated significantly (P < 0.05). When these same histological characteristics were used to compare survival, the capacity to separate invasive cancers into two groups having good and poor survival probabilities was evident, with a significant improvement for the screen detected poor survival group compared with controls (P < 0.05).