Obvious peritumoral emboli: an elusive prognostic factor reappraised. Multivariate analysis of 1320 node-negative breast cancers
Obvious peritumoral emboli: an elusive prognostic factor reappraised. Multivariate analysis of 1320 node-negative breast cancers
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DOI：
10.1016/s0959-8049(97)00344-4
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发表时间：
1998-01-01
影响因子：
8.4
通讯作者：
Trojani, M
中科院分区：
文献类型：
--
作者：
de Mascarel, I;Bonichon, F;Trojani, M
本研究旨在通过对可手术淋巴结阴性乳腺癌患者进行简单的常规切片检查，前瞻性确定明显瘤周血管栓塞对预后的影响。明显的瘤周栓塞（OPE）定义为在癌边缘附近但在癌边缘外的明确血管腔内（包括淋巴间隙和毛细血管）存在肿瘤栓塞。从1975年到1992年，我们对1320例原发性可手术淋巴结阴性乳腺癌的5 μ m厚苏木精和伊红染色切片进行了OPE常规评估。OPE和其他预后变量（肿瘤大小，SBR分级，雌激素和孕激素受体状态）与总生存期（OS）和无转移间隔（MFI）相关，通过单变量和多变量分析，中位随访时间为103个月。在19.5%的肿瘤中发现OPE。在单变量分析中，OPE与肿瘤大小（P=6.3 x 10（-5））和组织学分级（P=4.9 x 10（-7））相关。发现与OS（P=4.6 x 10（-5））和MFI（P=6.4 x 10（-9））具有统计学显著相关性。此外，在多变量分析中，OPE是一个独立的预后变量，在肿瘤大小和分级之前是MFI的最佳预测因素（P=7.7 x 10（-7）），在肿瘤分级之后是OS的第二个预测因素（P=0.002）。本研究是一项大型单中心系列研究，随访时间较长，证实了可手术淋巴结阴性乳腺癌患者血管栓塞的预后意义。重要的是，发现血管栓塞可以通过简单的常规和非耗时的方法准确检测。因此，在淋巴结阴性乳腺癌患者中，这种明显的血管栓塞应被视为一个重要的成本效益和预后变量。(C)1998年由Elsevier Science Ltd.出版
This study was conducted to determine the prognostic influence of obvious peritumoral vascular emboli as prospectively determined by a simple routine slide examination in patients with operable node-negative breast cancer. Obvious peritumoral emboli (OPE) were defined by the presence of neoplastic emboli within unequivocal vascular lumina (including both lymphatic spaces and blood capillaries) in areas adjacent to but outside the margins of the carcinoma. OPE were assessed routinely on 5 mu m thick haematoxylin and eosin-stained sections for each of 1320 primary operable node-negative breast cancers from 1975 to 1992 at our institution. OPE and other prognostic variables (tumour size, SBR grade, oestrogen and progesterone receptor status) were correlated to overall survival (OS) and metastasis-free interval (MFI) by means of univariate and multivariate analysis with a median follow-up of 103 months. OPE were found in 19.5% of tumours. In univariate analysis, OPE were related to tumour size (P=6.3 x 10(-5)) and histologic grade (P=4.9 x 10(-7)). Statistically significant correlations were found with OS (P=4.6 x 10(-5)) and MFI (P=6.4 x 10(-9)). Furthermore, in multivariate analysis, OPE was an independent prognostic variable, the most predictive factor for MFI (P=7.7 x 10(-7)) before tumour size and grade, and was second after tumour grade for OS (P=0.002). This study on a large unicentric series and with a long follow-up confirms the prognostic significance of vascular emboli in patients with operable node-negative breast carcinoma. Importantly, vascular emboli were found to be accurately detectable by a simple routine and non-time-consuming method. Therefore, such obvious vascular emboli should be considered as an important cost-effective, prognostic variable in patients with node-negative breast carcinoma. (C) 1998 Published by Elsevier Science Ltd.