The growth law of primary breast cancer as inferred from mammography screening trials data.
The growth law of primary breast cancer as inferred from mammography screening trials data.
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DOI：
10.1038/bjc.1998.503
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发表时间：
1998-08
影响因子：
8.8
通讯作者：
Agur, Z
中科院分区：
文献类型：
--
作者：
Hart, D;Shochat, E;Agur, Z
尽管在了解肿瘤发展方面取得了相当大的进展，但人类肿瘤的生长规律仍然存在一些争议。本研究利用大规模乳腺钼靶筛查试验数据，推断原发性乳腺癌的生长规律。我们比较了从这些数据推断的原发性乳腺癌的经验性肿瘤群体大小分布与对应于各种可能的理论生长函数的分布。由此，我们发现，数据是不符合指数，逻辑和Gompertz法律，但支持幂律增长（指数约0.5）。该定律表明无限制增长，但具有缓慢的质量比增长率和倍增时间。在临床尺寸范围内，这意味着质量比生长率的下降幅度大于Gompertz定律使用可接受参数预测的下降幅度。这表明，大肿瘤对周期特异性疗法的敏感性较低，并且首先通过非细胞周期特异性药物进行更好的治疗。我们讨论了使用我们的研究来估计乳腺X线摄影检测小肿瘤的灵敏度。例如，我们估计，乳房X光检查在检测1至1.5厘米范围内的肿瘤时，其灵敏度比检测较大肿瘤时低约30%。
Despite considerable progress in understanding tumour development, the law of growth for human tumours is still a matter of some dispute. In this study, we used large-scale mammography screening trial data to deduce the growth law of primary breast cancer. We compared the empirical tumour population size distributions of primary breast cancer inferred from these data to the distributions that correspond to various possible theoretical growth functions. From this, we showed that the data are inconsistent with the exponential, logistic and Gompertz laws, but support power law growth (exponent approximately 0.5). This law indicates unbounded growth but with slowing mass-specific growth rate and doubling time. In the clinical size ranges, it implies a greater decline in the mass-specific growth rate than would be predicted by the Gompertz law using the accepted parameters. This suggests that large tumours would be less sensitive to cycle-specific therapies, and be better treated first by non-cell cycle-specific agents. We discussed the use of our study to estimate the sensitivity of mammography for the detection of small tumours. For example, we estimated that mammography is about 30% less sensitive in the detection of tumours in the 1 to 1.5-cm range than it is in detecting larger tumours.