乳腺癌患者的DNA倍体、S期细胞比率、激素受体和淋巴结转移的检测

DETECTION OF DNA PLOIDY,SPF,ER AND LYMPHNODE METASTASIS IN BREAST CANCER

目的探讨ＤＮＡ倍体、Ｓ期细胞比率（ＳＰＦ）、激素受体和淋巴结转移与肿瘤恶性程度和患者预后的关系。方法用流式细胞术和免疫组织化学技术同步检测１２８例女性乳腺癌患者的ＤＮＡ倍体、Ｓ期细胞比率、雌激素受体（ＥＲ）和淋巴结转移（ＬＮＭ）等４项指标。结果ＥＲ（—）患者的异倍体率、ＳＰＦ和ＬＮＭ（＋）率均显著高于ＥＲ（＋）患者（分别为９３．３％、３０．７±７．２％、８０．０％和６４．０％、１５．２±６．２％、５２．０％，Ｐ＜０．０５或Ｐ＜０．０１）。异倍体患者ＳＰＦ、ＥＲ（－）率也显著高于二倍体患者（分别为２３．１％±１０．１％、３１．０％和１３．４％±５．３％、８．７％，Ｐ＜０．０５或Ｐ＜０．０１）。根据患者对４项指标反应程度不同，将患者分为预后好坏程度不同的５级，“１”级各项指标均为预后较好指标，而“５”级各项指标均为预后不好指标。这样从“１”级到“５”级患者肿瘤恶性度越来越高，预后越来越差，其５年生存率分别为１００％、８７．２％、６８．７％、３５．７％和２３．１％。结论ＤＮＡ倍体、细胞增殖特性、激素受体表达和淋巴结转移是反映肿瘤恶性程度和判断预后的重要参数。

To study the relationship of tumor malignancy and patient prognosis to DNA ploldy, Sphase fraction,estrogen receptors and lymphnode metastasis (LNM) in breast cancer.METhODS DNA ploidy, SPF, ER and lymphnode metastases were measured by synchronally onsamples from 128 female breast cancer patients.RESULts DNA neuploidy rate, SPF and LNM (+ ) rates in patients with neuploid tumors werehigher than those with ER(+ ) (93. 3%, 30. 7+/-7. 2%, 80% and 64%, 15. 2% +/- 6. 2%, 52% ) respectively (P<0. 05 or P<0. 01 ). SPF and ER (-) rates in patients with neuploid tumors were higherthan those with diploid tumors (23. 1 % +/- 10. 1 %, 31 % and 13. 4 +/- 5. 3%, 8. 7 % ) respectively (P<0. 05 or P<0. 01). The patients were graded into 5 categories depending on their reactions to the 4 criteria. Grade I patients were those with all 4 critierae being good, and Grade 5 were those with all critieriaebeing bad. Thus the malignancy of the tumors gradually increased and prognosis became gradually worsewith grade of patients from 1 to 5. The five year survival rated in each group was 100 %, 87. 5 %,68. 7 %,35. 7 % and 23. 1 % respectively.CONCLUSIONS The above results provide objective evidence for grading patients as regards prognosis in breast cancer.