The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer.
The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer.
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全身性炎症反应，肿瘤增殖活性，T淋巴细胞和巨噬细胞浸润，微血管密度和生存率之间的关系之间的关系之间的关系是原发性可手术乳腺癌的患者之间的关系。
DOI：
10.1038/sj.bjc.6604667
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发表时间：
2008-10-07
影响因子：
8.8
通讯作者：
McMillan, D. C.
中科院分区：
文献类型：
--
作者：
Al Murri, A. M.;Hilmy, M.;Bell, J.;Wilson, C.;McNicol, A-M;Lannigan, A.;Doughty, J. C.;McMillan, D. C.
肿瘤和宿主局部/全身炎症反应在原发性可手术浸润性乳腺癌中的相互关系的意义是有限的。采用免疫组织化学和切片计数技术检测全身炎症反应（术前白细胞计数、c反应蛋白和白蛋白浓度）、标准临床病理因素、肿瘤t淋巴细胞（CD4+和CD8+）和巨噬细胞（CD68+）浸润、增殖（Ki-67）指数和微血管密度（CD34+）之间的相互关系。并对168例早期浸润性乳腺癌行根治性切除的患者进行预后评价。肿瘤分级和增殖活性增加与肿瘤t淋巴细胞（P<0.05）、巨噬细胞（P<0.05）浸润和微血管密度增加相关（P<0.01）。幸存者的中位随访时间为72个月。在此期间，31名患者死亡；18人死于癌症。在单因素分析中，淋巴结累及增加（P<0.01）、激素受体阴性（P<0.10）、白蛋白浓度降低（P<0.01）、肿瘤增殖增加（P<0.05）、肿瘤微血管密度增加（P<0.05）、局部区域控制程度（P<0.0001）和有限的全身治疗（P<0.01）与癌症特异性生存相关。在这些重要协变量的多变量分析中，白蛋白（相对危险度4.77,95% CI 1.35-16.85， P=0.015）、局部区域治疗（相对危险度3.64,95% CI 1.04-12.72， P=0.043）和全身治疗（相对危险度2.29,95% CI 1.23-4.27， P=0.009）是癌症特异性生存的重要独立预测因子。在基于肿瘤的炎症因子中，只有肿瘤微血管密度与较差的肿瘤特异性生存率独立相关（P<0.05）。宿主炎症反应与乳腺癌肿瘤分化不良、增殖和恶性疾病进展密切相关。
The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P<0.05) and macrophage (P<0.05) infiltration and microvessel density (P<0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P<0.01), negative hormonal receptor (P<0.10), lower albumin concentrations (P<0.01), increased tumour proliferation (P<0.05), increased tumour microvessel density (P<0.05), the extent of locoregional control (P<0.0001) and limited systemic treatment (P⩽0.01) were associated with cancer-specific survival. On multivariate analysis of these significant covariates, albumin (HR 4.77, 95% CI 1.35–16.85, P=0.015), locoregional treatment (HR 3.64, 95% CI 1.04–12.72, P=0.043) and systemic treatment (HR 2.29, 95% CI 1.23–4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P<0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer.
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