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目的 对比分析淋巴结转移情况不同的乳腺浸润性导管癌病理预后因素。探讨其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 ,测定淋巴结阳性 13 7例和阴性 2 0 6例病例的癌实质体积密度 (Vv)及癌巢的表面积密度 (Sv) ;以Bloom Richardson和Elston分级法进行组织学分级。比较淋巴结情况不同时Sv、Vv及组织学分级与预后的关系。结果 无论淋巴结情况及组织学分级如何 ,Sv与预后负相关 ,Vv与预后正相关。癌巢表面积密度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。淋巴结阳性组的Sv值高于阴性组 (P <0 .0 1)。此结果Sv正判率 (CA ) 89.2 6%、灵敏度 (SE) 0 .92 5 0、特异度 (SP) 0 .82 93。结论 癌肿生长方式的体视学参数 -Sv值可作为独立判断预后的指标。高Sv值与淋巴结转移关系密切 ,高Sv值同时淋巴结阳性是 5年内死亡的高危因素 ,而Vv、淋巴结转移、组织学分级是乳腺浸润性导管癌预后的相关因素
Objective To compare and analyze the pathological prognostic factors of breast invasive ductal carcinoma with different lymph node metastasis. To investigate the value of stereological parameters in judging the prognosis. Methods According to the stereological principle, the Vv and the Sv of cancerous nests were determined by the template method in 13 7 cases with negative lymph nodes and 206 cases with negative staining. The Bloom Richardson and Elston grading methods Histological grade. To compare the relationship between Sv, Vv, histological grade and prognosis when lymph nodes were not different. Results Regardless of lymph node status and histological grade, Sv was negatively correlated with prognosis, and Vv was positively correlated with prognosis. Cancer nest surface area density Sv ≤ 4.4 89.3% of patients survived for more than 5 years, said safe, Sv> 5.5 patients 82.5% died within 5 years, said the dangerous type. In addition, patients with Sv <1.8 survived for more than 5 years and patients with Sv> 9.4 died within 5 years. The Sv of lymph node positive group was higher than that of negative group (P <0.01). The results showed that Sv had a positive rate of 89.2% (CA), a sensitivity of 0.9250, and a specificity of 0.82. Conclusion Stereological parameters of the growth pattern of cancer - Sv value can be used as an independent prognostic indicator. High Sv values are closely related to lymph node metastasis. High Sv values and lymph node positive are the risk factors for death within 5 years. Vv, lymph node metastasis and histological grade are the prognostic factors of breast invasive ductal carcinoma