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在衡量预期效果和副作用之间决定乳癌患者是否需要辅加治疗.腋窝淋巴结转移的乳癌预示早期复发可能,常为化疗的指征,而淋巴结阴性者预后较好,一般不主张辅加治疗;但是5年远处转移率大约25%～30%,终致死亡.过去研究指出辅加内分泌治疗或细胞毒化疗,可延长淋巴结阴性乳癌(NNBC)患者无癌存活率,然而有2/3患者可不必进一步治疗.作者曾指出胞膜磷脂A_2(M-PLA_2)、多核白血球弹性蛋白酶(PMN-E)、组织纤维蛋白激酶(t-PA)、尿激酶型纤维蛋白激酶(u-PA)和内皮-1(ET-1)是乳癌细胞产物,可影响疾病的进展.对Ⅰ、Ⅱ、Ⅲ、期乳癌患者的初步研究显示这些因子和乳癌预后相关联.本研究将评估上述生物因子对NNBC患者的预后价值.1982～1987年,184例NNBC随机分为两组.第一组仅作手术(Halstead或保留胸大肌的改良式乳癌根治术),第二组手术后用三苯氧胺(tamoxifen)治疗(20mg/日)持续2年.常规手术后最初2年每月和以后每三个月进行随访.平均随访8.3年(5.5～10.5年).结果显示M-PLA_2、PMN-E、t-PA、
To determine whether breast cancer patients need additional treatment to measure the expected effect and side effects. Breast cancer with axillary lymph node metastasis may indicate early recurrence, often as an indicator of chemotherapy, whereas lymph node-negative patients have a better prognosis and generally do not advocate adjuvant therapy; The 5-year distant metastasis rate is about 25% to 30%, eventually leading to death. Previous studies have indicated that the addition of endocrine therapy or cytotoxic chemotherapy can prolong the cancer-free survival of patients with node-negative breast cancer (NNBC), however, 2/3 of patients can No further treatment is required. The authors have pointed out that the membrane phospholipid A2 (M-PLA2), polynuclear leukocyte elastase (PMN-E), tissue fibrin kinase (t-PA), urokinase-type fibrin kinase (u-PA) and endothelial -1 (ET-1) is a product of breast cancer cells that can affect the progression of the disease. Preliminary studies of patients with I, II, III, and breast cancer have shown that these factors are associated with breast cancer prognosis. This study will evaluate the above biological factors for NNBC patients. The prognostic value. From 1982 to 1987, 184 NNBC were randomly divided into two groups. The first group was operated only (Halstead or modified radical mastectomy), and the second group was treated with tamoxifen. (20mg/day) lasts 2 years. Follow-up was performed every month and every three months after the routine surgery. The average follow-up period was 8.3 years (5.5 to 10.5 years). The results showed that M-PLA_2, PMN-E, t-PA,