Prediction of Oncotype DX Recurrence Score Based on Systematic Evaluation of Ki-67 Scores in Hormone Receptor-Positive Early Breast Cancer.

IF 2.2 4区 医学 Q3 ONCOLOGY Journal of Breast Cancer Pub Date : 2024-06-01 DOI:10.4048/jbc.2024.0065
Ji Min Kim, Eun Yoon Cho
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Abstract

Purpose: Oncotype DX (ODX) predicts the risk of recurrence and benefits of adding chemotherapy for patients with estrogen receptor positive (ER+)/human epidermal growth factor receptor 2 negative (HER2-) early-stage breast cancer. We aimed to develop a simplified scoring system using readily available clinicopathological parameters to predict a high-risk ODX recurrence score (RS) while minimizing reproducibility issues regarding Ki-67 index evaluation methods.

Methods: We enrolled 300 patients with ER+/HER2- early breast cancer, for whom ODX RS data were available in the test set. Using the QuPath image analysis platform, we systematically evaluated the average, hotspot, and hottest spot Ki-67 scores in the test set. Logistic regression analyses were conducted to establish a predictive scoring system for high-risk ODX RS. An independent validation set comprising 117 patients over different periods was established.

Results: Factors such as age ≤ 50 years, invasive ductal carcinoma tumor type, histologic grade 2 or 3, tumor necrosis, progesterone receptor negativity, and a high Roche-analyzed Ki-67 score (> 20) were associated with high-risk ODX RS. These variables were incorporated into our scoring system. The area under the curve of the scoring system was 0.8057. When applied to both the test and validation sets with a cutoff value of 3, the sensitivity of our scoring system was 92%.

Conclusion: We successfully developed a scoring system based on the systematic evaluation of Ki-67 scoring methods. We believe that our user-friendly predictive scoring system for high risk ODX RS could help clinicians in identifying patients who may or may require additional ODX testing.

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基于对激素受体阳性早期乳腺癌 Ki-67 评分的系统评估预测 Oncotype DX 复发评分
目的:Oncotype DX(ODX)可预测雌激素受体阳性(ER+)/人表皮生长因子受体2阴性(HER2-)早期乳腺癌患者的复发风险和增加化疗的益处。我们旨在开发一种简化的评分系统,利用现成的临床病理参数预测高风险 ODX 复发评分 (RS),同时尽量减少 Ki-67 指数评估方法的可重复性问题:我们招募了300名ER+/HER2-早期乳腺癌患者,测试集中有这些患者的ODX RS数据。利用 QuPath 图像分析平台,我们对测试集中的平均、热点和最热点 Ki-67 分数进行了系统评估。我们进行了逻辑回归分析,以建立高风险 ODX RS 的预测评分系统。结果:年龄小于50岁、浸润性导管癌肿瘤类型、组织学分级2级或3级、肿瘤坏死、孕酮受体阴性、罗氏分析Ki-67高分(> 20)等因素与高风险ODX RS相关。这些变量被纳入了我们的评分系统。评分系统的曲线下面积为 0.8057。当应用于截止值为 3 的测试集和验证集时,我们的评分系统的灵敏度为 92%:我们在对 Ki-67 评分方法进行系统评估的基础上,成功开发了一套评分系统。我们相信,我们的用户友好型高风险 ODX RS 预测评分系统可以帮助临床医生识别可能或可能需要进行额外 ODX 检测的患者。
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来源期刊
Journal of Breast Cancer
Journal of Breast Cancer 医学-肿瘤学
CiteScore
3.80
自引率
4.20%
发文量
43
审稿时长
6-12 weeks
期刊介绍: The Journal of Breast Cancer (abbreviated as ''J Breast Cancer'') is the official journal of the Korean Breast Cancer Society, which is issued quarterly in the last day of March, June, September, and December each year since 1998. All the contents of the Journal is available online at the official journal website (http://ejbc.kr) under open access policy. The journal aims to provide a forum for the academic communication between medical doctors, basic science researchers, and health care professionals to be interested in breast cancer. To get this aim, we publish original investigations, review articles, brief communications including case reports, editorial opinions on the topics of importance to breast cancer, and welcome new research findings and epidemiological studies, especially when they contain a regional data to grab the international reader''s interest. Although the journal is mainly dealing with the issues of breast cancer, rare cases among benign breast diseases or evidence-based scientifically written articles providing useful information for clinical practice can be published as well.
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