P. Lipponen et al., APOPTOSIS IN BREAST-CANCER AS RELATED TO HISTOPATHOLOGICAL CHARACTERISTICS AND PROGNOSIS, European journal of cancer, 30A(14), 1994, pp. 2068-2073
Appoptotic cells were quantitated by light microscopy in a series of 2
88 breast carcinomas, and their number (cells/mm(2) of neoplastic epit
helium, i.e., the apoptotic index, AI) was related to various histopat
hological features and disease outcome. High AI was associated with tu
mour necrosis (P = 0.003), lack of tubule formation (P = 0.03), dense
stromal lymphocyte infiltration (P = 0.0009), high grade of the tumour
(P < 0.0001), DNA aneuploidy (P = 0.049), high S-phase fraction (P =
0.010), high mitotic rate (P < 0.0001), lack of sex steroid receptors
(P = 0.004), expression of p53 tumour suppressor gene (P = 0.004), and
high values of morphometrically measured nuclear factors (P < 0.05).
In survival analysis, an AI greater than 3/mm(2) was related to short
recurrence-free survival in the entire cohort (P = 0.0079) as well as
in the axillary lymph node-negative tumours (P = 0.0253). Survival of
the patients with node-negative tumours (P = 0.0356), node-positive tu
mours (P = 0.0085) and in the entire cohort (P = 0.004) was related to
AI. Recurrence-free survival was related to the mitotic index (P = 0.
0012), ductal type (P = 0.011), S.D. of the nuclear area (P = 0.075),
and axillary lymph node status (P = 0.096). Cox's analysis showed that
only the tumour diameter (P < 0.001), axillary lymph node status (P =
0.001), progesterone receptor content (P = 0.004) and ductal type (P
= 0.041) had independent prognostic value, whereas AI did not.