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DOI: 10.1055/s-2003-43040
© Georg Thieme Verlag Stuttgart · New York
Bedeutung DNA-Bild-zytometrischer Parameter und etablierter Prognosefaktoren für krankheitsfreies Überleben (DFS) und Gesamtüberleben (OS) nodal-negativer Mammakarzinompatientinnen
Impact of DNA Image Cytometry (ICM) Parameter and Established Prognostic Factors on Disease Free Survival (DFS) and Overall Survival (OS) of Node-Negative Breast Cancer (NNBC) PatientsPublikationsverlauf
Publikationsdatum:
21. Oktober 2003 (online)
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Zusammenfassung
Fragestellung: DNA-Bild-zytometrische Messungen ermöglichen ein Malignitätsgrading. Ziel der Untersuchung war es, die mittels DNA-Bild-Zytometrie gemessenen Parameter im Vergleich mit etablierten Prognosefaktoren auf ihre prognostische Bedeutung bezüglich krankheitsfreiem Überleben (DFS) und Gesamtüberleben (OS) zu überprüfen.
Patientinnen und Methode: 177 nicht selektionierte primäre Mammakarzinome wurden einer DNA-Bild-Analyse unterzogen. Die ermittelten Parameter 2cDeviationsindex (2cDI), 5c und 9cExceeding Events (5cEE, 9cEE), DNA-Mittelwert, Malignitätsgrad, Proliferationsphase (SG2M) und Ploidie wurden zusammen mit den etablierten Prognosefaktoren pT-Stadien, Histologie, Grading, Hormonrezeptorstatus und Alter der Patientinnen in univariater und multivariater Analyse zu DFS und OS korreliert.
Ergebnisse: Univariat zeigten bis auf die Ploidie-Messungen alle DNA-Parameter zusammen mit pT-Stadien, Histologie, Grading und Alter eine signifikante Beziehung zu DFS. In multivariater Analyse behielten nur 2cDI und die pT-Stadien unabhängige prognostische Bedeutung. Bezüglich OS waren in univariater Analyse 9cEE zusammen mit Histologie und pT-Stadien relevant. Multivariat behielten nur 9cEE und pT-Stadien einen unabhängigen prognostischen Einfluss.
Schlussfolgerung: Die DNA-Bild-zytometrischen Parameter 2cDI und 9cEE erwiesen sich neben dem etablierten Prognosefaktor pT-Stadien als unabhängige prognostische Faktoren für das nodal-negative Mammakarzinom.
Abstract
Objective: DNA ICM allows measurement of nuclear DNA content and genotypical grading of malignancy. The aim of this study was to prove the prognostic value of DNA parameter in comparison to established prognostic factors for DFS and OS.
Patients and Methods: Cytological imprints of 177 unselected primary NNBC patients were subjected to ICM. ICM parameter 2cDI, 5cEE, 9cEE, DNA mean value, proliferation fraction (SG2M) and ploidy were investigated together with established parameter like pT-stages, histology, grading, hormone receptor status and patient age regarding DFS and OS. Univariate and multivariate analysis were performed.
Results: Univariate analysis revealed that except ploidy all ICM parameter and pT-stages, histology as well as grading were significant prognostic factors for DFS. However, only 2cDI and pT-stages were proved independent prognostic factors in multivariate analysis. Regarding OS 9cEE, histology and pT-stages were significant factors in univariate analysis. However, only 9cEE and pT-stages were found to be independent prognostic factors in multivariate analysis.
Conclusions: DNA - ICM parameter 2cDI and 9cEE together with pT-stages were proved independent prognostic factors in NNBC patients.
Schlüsselwörter
Nodal-negatives Mammakarzinom - DNA-Bild-Zytometrie - Prognosefaktoren - krankheitsfreies Überleben - Gesamtüberleben
Key words
Node-negative breast cancer - DNA image cytometry - prognostic factors - disease free survival - overall survival
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PD Dr. med. Dr. med. habil. C. M. Schlotter
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