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題 名 | Prognostic Factors in Node-Negative Breast Cancer Patients: The Experience in Taiwan=腋下淋巴未轉移之乳癌病人預後分析:臺灣經驗 |
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作 者 | 陳訓轍; 趙子傑; 黃燦龍; 鄭隆賓; 詹益銀; 王嘉修; 陳敏夫; 薛綏; 曹國倩; 孫建峰; | 書刊名 | 長庚醫學 |
卷 期 | 21:4 1998.12[民87.12] |
頁 次 | 頁363-370 |
分類號 | 416.226 |
關鍵詞 | 乳癌; 預後因子; 流式細胞儀; Breast cancer; Prognostic factors; DNA flow cytometry; |
語 文 | 英文(English) |
中文摘要 | 背景:腋下淋巴未轉移之乳癌病人有百分之二十五的再發機會。而化學治療及延 長某些高危險群之存活率,所以分析何者為高復發病人而選擇性的予以補助治療是必要的。 方法:長庚紀念醫院林口醫學中心於1981到1986年間共有255位腋下淋巴未轉移的乳癌病人 于術後皆未接受任何輔助性治療(包括化學、荷爾蒙及放射線治療)。其中有145位病人的組 織包埋片可用于做流式細胞儀的分析。我們就以臨床表徵,病理組織及腫瘤的套體數來分析 病人的預後。 結果:平均追蹤時間為121個月,而10年的無病存活率分別為75.1%及82.2%。分析10年存 活率;有較差預後的因素包括腫瘤大於3公分,動情素接受體陰性,及非雙套體。病人接受 冷凍切片,組織學分級為第二、三級者預後稍差,但不具統計上的意義。而病人若為陽性動 情素接受體94%沒有再發。腫瘤小於2公分而組織學分級為第一級時有92%沒有再發。 結論:腋下淋巴未轉移之乳癌病人其10年的存活率為82.2%,動情素接受體陽性病人,腫瘤 小於2公分且組織學分級為第一級者甚少再發,可不必接受任何輔助治療。而原位癌的病人 ,在10年的追蹤內皆未有局部或遠處再發,也不需任何輔助治療。 |
英文摘要 | Backgrounp: Adjuvant chemotherapy has improved the length of disease-free survival and overall survival in node-negative breast cancer patients. It has been a common practice to select only the patients with higher rates of recurrence for adjuvant therapy. Therefore, it is essential to define the risk factors in node-negative breast cancer patients. Materials and Methods: Two hundred fifty-five patients with axillary node-negative breast cancers without adjuvant chemotherapy or hormonal therapy at Chang Gung Memorial Hospital between 1981 and 1986 were included in this study. Tissue block for DNA flow cytometry study was available in the tumors of 145 patients. Results: The median follow-up period was 121 months and the percentages of patients with 10 years of disease-free survival(DFS) and overall survival(OS) were 75.1% and 82.2%, respectively. The significant poor prognostic factors for 10 years of OS were a tumor size larger than 3 cm, negative estrogen and progesterone receptor status, and having a non-diploid tumor(p value= 0.0176, 0.048 and 0.016, respectively). The patients with frozen section, high mitotic rate, and Scarff-Blood-Richardson(SBR) grade Ⅱ and Ⅲ tumors had a worse prognosis than the others,but this trend did not reach statistical significance. The patients with positive estrogen receptor status had a 10-year disease-free rate(DFR) of 94%, and these with tumors less than 2 cm plus SBR grade Ⅰ had a 10-year DFR of 92%. Conclusion: The node-negative breast cancer patients with a low risk of recurrence were those who had estrogen receptor positive, tumors less than 2 cm with SBR grade Ⅰ, and intraductal carcinomas. Adjuvant chemotherapy would be no benefit for these patients. |
本系統中英文摘要資訊取自各篇刊載內容。