Which is the better pathological prognostic factor, the Nottingham histological grade or the Japanese nuclear grade? A large scale study with a long-term follow-up

被引:9
作者
Otsuki, Yoshiro
Shimizu, Shin-ichi
Suwa, Kaori
Yoshida, Masayuki
Kanzaki, Masao
Kobayashi, Hiroshi
机构
[1] Seirei Hamamatsu Gen Hosp, Dept Pathol, Hamamatsu, Shizuoka 4308558, Japan
[2] Seirei Hamamatsu Gen Hosp, Dept Breast Surg, Hamamatsu, Shizuoka, Japan
[3] Kanzaki Clin, Hamamatsu, Shizuoka, Japan
关键词
breast cancer; histological grade; pathological grade; prognostic factor; INTERNATIONAL EXPERT CONSENSUS; EARLY BREAST-CANCER; PRIMARY THERAPY; HIGHLIGHTS; CARCINOMA;
D O I
10.1093/jjco/hym026
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: We compared the Nottingham histological grade (H-grade) and the Japanese nuclear grade (N-grade) to select the better prognostic factor for breast cancers. Methods: The series included 1786 patients with breast cancers with the exception of non-invasive and stage 4 cancers. They were classified according to the H- and N-grade. We analyzed their survival curves and also performed multivariate Cox regression analyses. Results: According to the H-grade classification, 476 cases were grade 1, 647 cases were grade 2 and 663 cases were grade 3. According to the N-grade, 381 cases were grade 1, 215 cases were grade 2, and 1129 cases were grade 3. In the survival curves of those cases with lymph node metastases (N(+)) and recurrent cases, there were statistically significant differences in different categories of the H-grades, but not in the N-grades. The survival curves of all the cases and those cases without lymph node metastases (N(-)) always exhibited statistically significant differences. According to the 2003 St Gallen consensus, the N(-) group was classified as a minimal risk and an average risk groups. Both H- and N-grade exhibited statistically significant differences between the minimal risk and the average risk groups in the disease-free survival. The multivariate analyses proved that the H-grade was a statistically significant prognostic factor in all the cases and N(+) group, but the N-grade was not significant in any of the studies. Conclusions: The H-grade is clearly proved to be a more significant prognostic factor for wider stage cases than the N-grade.
引用
收藏
页码:266 / 274
页数:9
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