原发性乳腺癌骨髓微转移:6年随访后的预后意义

J.L. Mansi , D. Easton , U. Berger , J.-C. Gazet , H.T. Ford , D. Dearnaley , R.C. Coombes
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引用次数: 201

摘要

我们使用抗上皮膜抗原血清筛选了350例初次手术时抽取的原发性乳腺癌患者的多次骨髓抽吸。89例(25%)患者发现微转移,其存在与病理大小有关(P <0.01),肿瘤周围血管侵犯的存在(P <0.001),淋巴结阳性(P <0.005),但与绝经期无关。在中位随访76个月(范围34-108)时,107例患者复发并发生远处转移。这些患者中48%(89人中43人)最初有微转移,而25%(261人中64人)没有微转移(P <0.005)。该试验预测骨复发(P <0.01)和其他远端部位(不包括骨)(P <0.001),并与较短的总生存期相关(P <0.005)。我们得出结论,微转移的检测表明乳腺癌早期复发和生存率降低的可能性很高。
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Bone marrow micrometastases in primary breast cancer: Prognostic significance after 6 years' follow-up

Using an antiserum to epithelial membrane antigen we have screened multiple bone marrow aspirates from 350 patients with primary breast cancer taken at the time of initial surgery. 89 (25%) patients were found to have micrometastases and their presence was related to pathological size (P < 0.01), the presence of peritumoral vascular invasion (P < 0.001), and positive lymph nodes (P < 0.005) but not menopausal status. At a median follow-up of 76 months (range 34–108) 107 patients had relapsed with distant metastases. 48% (43 of 89) of these patients had micrometastases initially compared with 25% (64 of 261) who did not (P < 0.005). The test predicts for relapse in bone (P < 0.01) and other distant sites excluding bone (P < 0.001) and is associated with a shorter overall survival (P < 0.005). We conclude that the detection of micrometastases signals a high likelihood of early relapse and decreased survival in breast cancer.

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