Prognostic value of steroid hormone receptors: multivariate analysis of systemically untreated patients with node negative primary breast cancer.
Prognostic value of steroid hormone receptors: multivariate analysis of systemically untreated patients with node negative primary breast cancer.
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类固醇激素受体的预后价值：对未经系统治疗的淋巴结阴性原发性乳腺癌患者的多变量分析。
作者：
S. Thorpe;C. Rose;B. Rasmussen;H. Mouridsen;T. Bayer;Niels Keiding
雌激素和孕激素受体（分别为 ER 和 PgR）测定在预测无复发生存期 (RFS) 中的价值已在 807 名淋巴结阴性乳腺癌患者中进行了评估。所有这些患者均参加了丹麦乳腺癌合作组 (DBCG) 77-1a 和 82-a 低风险患者方案，且均未接受过全身辅助治疗。中位观察时间为 50 个月，在对整个患者群体作为一个整体进行评估时，ER+ 患者的 RFS 仅比 ER- 患者稍长（P = 0.07），而 PgR+ 患者则具有显着优势（P = 0.02）。在根据绝经状态分组的患者中，ER 和 PgR 状态被发现是预测绝经前女性（小于 50 岁）RFS 的重要预后因素，但对于围绝经期或绝经后女性则不然。使用 Cox 多变量分析，发现核多形性是唯一显着的预后变量，而 PgR 状态作为预后因素的价值接近显着性（P = 0.065）。尽管在已知 PgR 状态时，了解 ER 状态并不能显着区分相对较小的绝经前患者亚组 (n = 120) 中预后良好和不良的患者，但 ER+PgR- 患者的复发或死亡风险低于 ER-PgR- 患者。使用对数似然模型，发现绝经前患者受体阳性定义的显着且明显的截止限值：ER 为 5 fmol/mg 胞质蛋白，PgR 为 10 fmol/mg 胞质蛋白。这些截止水平可能反映了用于区分具有和不具有受体蛋白的组织的配体结合测定方法的能力。在预测淋巴结阴性绝经前患者疾病自然病程的 RFS 方面，受体状态的定性评估与受体浓度的定量表达一样有价值。
The value of estrogen and progesterone receptor (ER and PgR, respectively) determinations in predicting the recurrence-free survival (RFS) has been evaluated in a group of 807 node negative breast cancer patients. All of these patients are enrolled in the Danish Breast Cancer Cooperative Group (DBCG) 77-1a and 82-a protocols for low risk patients, and none of them have received systemic adjuvant therapy. At a median observation time of 50 months and in an evaluation of the total patient population as an entity, ER+ patients had only a marginally significant (P = 0.07) longer RFS than ER- patients while PgR+ patients experienced a significant advantage (P = 0.02). Among patients subgrouped according to menopausal status, both ER and PgR statuses were found to be significant prognostic factors for predicting RFS in the premenopausal women (less than 50 years) but not in peri- or postmenopausal women. Using Cox's multivariate analysis, nuclear pleomorphy was found to be the only significant prognostic variable, while the value of PgR status as a prognostic factor approached significance (P = 0.065). Although knowledge of ER status did not significantly improve distinction between patients with good and poor prognoses in the relatively small subgroup of premenopausal patients (n = 120) when PgR status was known, ER+PgR- patients have a lower risk of recurrence or death than ER-PgR- patients. Using a log-likelihood model, significant and distinct cut-off limits for the definition of receptor positivity were found for premenopausal patients: these were 5 fmol/mg cytosol protein for ER and 10 fmol/mg cytosol protein for PgR. These cut-off levels may reflect the ability of the ligand binding assay method used to discriminate between tissues with and without receptor proteins. Qualitative assessment of receptor status was as valuable as quantitative expression of receptor concentrations in predicting the RFS of the natural course of the disease among node negative premenopausal patients.
影响因子：
45.3
作者：
CLARK, GM;OSBORNE, CK;MCGUIRE, WL
通讯作者：
MCGUIRE, WL
DOI：
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发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox