Risk factors for local recurrence after breast-conserving therapy for invasive carcinomas: A case-control study of histological factors and alterations in oncogene expression
Risk factors for local recurrence after breast-conserving therapy for invasive carcinomas: A case-control study of histological factors and alterations in oncogene expression
复制标题
DOI：
10.1016/s0360-3016(99)00158-3
复制
发表时间：
1999-08-01
影响因子：
7
通讯作者：
van de Vijver, MJ
中科院分区：
文献类型：
--
作者：
Elkhuizen, PHM;Voogd, AC;van de Vijver, MJ
目的：许多研究都集中在保乳治疗（BCT）后局部复发（LR）的组织学危险因素上。除了组织学因素外，我们还采用病例对照方法研究了与LR相关的各种蛋白质表达的改变。
方法和材料：在接受BCT治疗的1481例肿瘤患者队列中，有99例发生LR。这些患者被随机匹配，每个病例匹配两名对照。匹配是按照年龄组（≤50岁和>50岁）、pN分期和随访时间进行的。对组织学切片进行了复查。对以下蛋白质进行了免疫组织化学染色：bcl - 2、CD31、细胞周期蛋白D1、E - 钙黏蛋白、表皮生长因子受体、雌激素受体（ER）、孕激素受体（PR）、Ki - 67、c - erbB2/neu和p53。采用条件逻辑回归进行统计分析。
结果：有66例浸润性癌病例和139例对照可供分析。以下变量是LR的显著危险因素：年轻（p = 0.006）、高核分级（p = 0.04）、高有丝分裂计数（p = 0.03）、肿瘤周围广泛的导管原位癌（DCIS）（p = 0.02，但肿瘤内无此情况）、分化差的DCIS类型（p = 0.03）、Ki - 67阳性细胞>20%（p = 0.006）以及PR阴性（p = 0.03）。当对年龄≤50岁和>50岁的患者分别进行分析时，这些危险因素在老年患者中存在，但在年轻患者中不存在。
结论：高有丝分裂计数和Ki - 67阳性是LR的危险因素。浸润性肿瘤周围的导管原位癌是LR的危险因素，尤其是分化差的类型。年龄是LR的一个重要危险因素，与其他危险因素（包括癌基因表达的改变）无关。（C）1999年爱思唯尔科学公司
Purpose: Many studies have focused on histological risk factors for local recurrence (LR) after breast-conserving therapy (BCT), In addition to histological factors, we studied alterations in the expression of various proteins in relation to LR using a case-control approach.Methods and Materials: Ninety-nine LR occurred in a patient cohort of 1,481 tumors treated with BCT. These patients were randomly matched, each with two controls. Matching was performed for age group (less than or equal to 50 and > 50 years), pN stage, and follow-up time. Histology slides were reviewed. Immunohistochemical staining was performed for the following proteins: bcl-2, CD31, cyclin D1, E-cadherin, EGF receptor, ER, PR, Ki-67, c-erbB2/neu, and p53. Statistical analyses were performed using conditional logistic regression,Results: Sixty-six cases and 139 controls with invasive carcinoma remained for analysis. The following variables were significant risk factors for LR: young age (p = 0.006), high nuclear grade (p = 0.04), high mitotic count (p 0.03), extensive DCIS around the tumor (p = 0.02) but not within the tumor, poorly differentiated type of DCIS (p = 0.03), > 20% ki-67 positive cells (p = 0.006), and PR negativity (p = 0.03), When the analysis was performed for patients I and > 50 years, these risk factors were found in the older patients, but not in the younger patients.Conclusion: High mitotic count and Ki-67 positivity are risk factors for LR, EDCIS surrounding the invasive tumor is a risk factor for LR, especially when of poorly differentiated type, Age is an important risk factor for LR independent of other risk factors, including alterations in oncogene expression. (C) 1999 Elsevier Science Inc.