Establishment of histological criteria for high-risk node-negative breast carcinoma for a multi-institutional randomized clinical trial of adjuvant therapy
Establishment of histological criteria for high-risk node-negative breast carcinoma for a multi-institutional randomized clinical trial of adjuvant therapy
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DOI：
10.1093/jjco/28.8.486
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发表时间：
1998-08-01
影响因子：
2.4
通讯作者：
Watanabe, T
中科院分区：
文献类型：
--
作者：
Tsuda, H;Akiyama, F;Watanabe, T
背景资料：在日本进行了一项针对高危淋巴结阴性（n 0）乳腺癌患者的辅助治疗的多机构随机临床试验。组织病理学小组，以建立组织学标准，以确定患者组复发率较高。方法：最初，三个病理学家独立判断的核等级，组成的核pathogenia和有丝分裂计数，100 n 0浸润性导管癌，专注于观察者之间的变化的核等级及其与患者预后的相关性。这些病理学家，然后给予共识的组织学类型和核等级为130个其他n 0乳腺癌和研究的预后意义的grade.Results：在第一项研究中，核等级2-3显着确定了一个病人组的复发率为17-20%的任何病理学家和协议的程度等级是公平的。在第二项研究中，共识类型和核分级确定了一组（n = 66）的复发率为22%，另一组（n = 64）的10年复发率为3.6%。在12个肿瘤中，肿瘤的切除固定间隔没有产生任何显着差异，有丝分裂counts.Conclusions：组织学类型和核等级清楚地确定了一个较高的风险患者组与n 0乳腺癌，并可能被应用到多机构的协议研究时，标准已经很好地标准化的病理学家。
Background: A multi-institutional randomized clinical trial of adjuvant therapy for patients with high-risk node-negative (n0) breast cancer has been undertaken in Japan. The pathology panel was organized in order to establish histological criteria to identify patient groups with higher rates of recurrence.Methods: Initially, three pathologists independently judged the nuclear grade, composed of nuclear atypia and mitotic counts, of 100 n0 invasive ductal carcinomas, focusing on interobserver variation of the nuclear grade and its correlation with patient prognosis. These pathologists then gave consensus histological types and nuclear grades for 130 other n0 breast carcinomas and examined the prognostic significance of the grade.Results: In the first study, nuclear grade 2-3 significantly identified a patient group with a rate of recurrence of 17-20% by any pathologists and the degree of agreement for the grade was fair. In the second study the consensus type and nuclear grade identified a group (n = 66) with a 22% recurrence rate and another group (n = 64) with a 3.6% recurrence rate at 10 years. In 12 tumors, the resection-fixation interval of the tumor did not generate any significant difference in mitotic counts.Conclusions: The histological type and the nuclear grade clearly identified a higher-risk patient group with n0 breast carcinoma, and may be applied to the multi-institutional protocol study when the criteria have been well standardized by the pathologists.