Histological differentiation, positiveness of hormonal receptors, ploidy of DNA and oncogenes are known prognostic factors in breast cancer. Recently, the Synthetic phase fraction(S-phase fraction) and the Proliferative Index(PI) of the cell
division
cycle have been considered as relating to parameters affecting the prognosis of cancer patients.
Authors intend to measured PI and evaluated it's significance as a prognostic factor in breast cancer. We analyzed PI's correlation with tumor size, lymph node involvement, pathologic differentiation, status of hormonal receptors and menopause
and
survival duration. PI was checked with flow cytometry using the paraffin-embedded tumor block of 70 patients.
@ES The results were as follows:
@EN 1) The mean value of PI was 31% and it's median value 30.4%.
2) The correlation between PI and size of tumor above or below 2cm was significant (Long-rank test p=0.0130). But there was no significant correlation between PI and node involvement, pathological differentiation (Long-rank test p=0.9371,
0.6550).
3) No significant correlation was found between PI and positiveness of estrogen, progesteron receptors(Long-rank test p=0.5475, 0.2866) and menopause status(Long-rank test p=0.4395) as well.
4) In a Cox multivariate multivariate model, PI(Cox model p=0.0374) an age(Cox model p=0.0470) emerged as significant independent predictors of overall survival. Patients with below the median PI values(30.4%), had significantly improved overall
survival and disease free survival compared with patients who ha dPIs above the median (Wilcoxon test p=0.0042, 0.0049). And also PI was independently significant in analysis of overall survival in lymph node positive subgroup(Wilcoxon text
p=0.0223).
5) S-phase fraction didn't have the ability to evaluate the difference both in node positive and negative group of patient's survival (Wilcoxon tst p=0.0366, 0.5329).
In conclusion, PI has a potential role as a prognostic factor especially in patients with over T2 tumor size and in lymph node positive breast cancer patients. And PI is more sensitive than S-phase fraction in breast cancer tissue.
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