体视学在乳腺浸润性导管癌中的应用

Application of stereology in breast invasive ductal carcinoma

目的 :研究乳腺浸润性导管癌生长方式的体视学参数对判断预后的价值。方法 :根据体视学原理 ,采用模板法 ,测定 3 4 3例乳腺浸润性导管癌的癌实质体积密度 (Vv)及癌巢的表面积密度 (Sv) ;观察H .E .切片进行淋巴结癌转移计数 ;以Bloom Richardson和Elston分级法进行组织学分级。比较Vv、Sv、淋巴结转移情况及组织学分级与预后的关系。结果 :癌实质体积密度 (Vv)及癌巢的表面积密度 (Sv)中 ,Sv≤ 4 4患者 89 3 %生存 5年以上 ,称安全型 ,Sv >5 5患者 82 5 %死于 5年以内 ,称危险型。此外 ,Sv <1 8患者 ,均生存 5年以上 ,Sv >9 4患者均死于 5年以内。此分类结果Sv正判率 89 2 6%、灵敏度 (SE) 0 92 5 0、特异度 (SP) 0 82 93。结论

Objective: To study the value of the stereologic parameter of growth pattern for the prognosis in breast invasive ductal carcinoma(IDC).Methods: Axillary lymph nodes status were assessed and graded according to the grading systems of Bloom Richardson and Elston by observing H.E. sections for 343 cases IDCs.Their volume density (Vv) of carcinomas substance and surface area density (Sv) of carcinomas nest were measured in stereologic principle and pattern method.The relationships between the variables and prognosis were compared respectively.Results: Lymph node status and histological grad are differential with 5 year survival rate significant statistically,and so are Vv,Sv.The Sv can signify IDCs prognosis independently by variables analysis,89.3 percent of the patients whose Sv figures are no more than 4.4 survived no less than 5 years,while 82.5 percent of the patients whose Sv figures are more than 5.5 survived less than 5 years.So the former Sv figure is a safe one,while the later is a danger one.The corrected rate of Sv is 89.26%,sensitivity 0.9250,specality 0.8293.Conclusion: Sv as a stereologic parameter of growth pattern is reliable and independent prognostic factor of breast invasive ductal carcinoma.