Prognostic value of steroid receptors after long-term follow-up of 2257 operable breast cancers.
Prognostic value of steroid receptors after long-term follow-up of 2257 operable breast cancers.
复制标题
长期随访2257种可手动乳腺癌后，类固醇受体的预后价值。
DOI：
10.1038/bjc.1996.291
复制
发表时间：
1996-06
影响因子：
8.8
通讯作者：
Asselain, B
中科院分区：
文献类型：
--
作者：
Pichon, M F;Broet, P;Magdelenat, H;Delarue, J C;Spyratos, F;Basuyau, J P;Saez, S;Rallet, A;Courriere, P;Millon, R;Asselain, B
通过对2257例可手术乳腺癌患者中位随访8.5年的多中心研究，评估了雌激素受体（ER）和孕激素受体（PR）的预后价值。所有患者均未接受过辅助治疗。该系列包括33.3%的I期患者、57.1%的II期患者、5.7%的IIIa期患者和2.4%的IIIb期患者。在研究结束时，记录了589例转移和537例癌症死亡。根据统一方案通过放射配体测定进行受体测量。ER阳性率为68.8%，PR阳性率为54.0%（胞浆蛋白≥ 10 fmol mg-1）。单因素分析中，ER、PR阳性/阴性对无病期（DFI）、无瘤期（MFI）和总生存期（OS）有预测价值（P < 0.001）。ER阳性和阴性肿瘤患者首次转移后的OS也有显著差异（P < 0.001）。在多变量分析中（考克斯比例风险模型，1665例患者），只有ER状态显示出显著差异（P < 0.01）。通过使用考克斯非比例、时间依赖性模型，我们表明原发性肿瘤ER状态的预测值每年下降约20%，在8年的随访后失去了意义。总体而言，与TNM和组织学分级相比，ER和PR状态的预后价值较低，其主要关注点仅限于治疗决策领域。
The prognostic value of oestrogen receptor (ER) and progesterone receptor (PR) was estimated through a multicentric study of 2257 operable breast cancer patients followed up for a median of 8.5 years. None of the patients had received adjuvant therapy. The series included 33.3% stage I patients, 57.1% stage II, 5.7% stage IIIa and 2.4% stage IIIb. At the end point of the study 589 metastases and 537 deaths from cancer were recorded. Receptor measurements were performed by radiolgand assay according to a uniform protocol. A total of 68.8% of the tumous were ER positive and 54.0% PR positive ( > or = 10 fmol mg-1 cytosol protein). In univariate analysis, ER and PR status (positive/negative) were of prognostic value (P < 0.001) for the disease-free interval (DFI), the metastases-free interval (MFI) and the overall survival (OS). The OS of the patients after a first metastasis was also significantly different between ER-positive and -negative tumours (P < 0.001). In multivariate analysis (Cox proportional hazard model, 1665 patients), only the ER status showed a significant difference (P < 0.01) between positive and negative groups regarding the DFI, MFI and OS. By using Cox non-proportional, time-dependent models, we show that the predictive value of ER status of the primary tumour decreases by approximately 20% per year, losing its significance after 8 years of follow-up. Overall, when compared with TNM and histological grading, ER and PR status have a low prognostic value, their major interest remaining solely in the domain of therapeutic decision.