切除的 T1-3 和 N0-1 乳腺癌病理特征与 OncotypeDX 复发评分之间的关系:北匈牙利地区中心的实际经验

Dániel Deme, B. Tamaskovics, Nizar Jammoul, Sándor Kovács, Emmanuel Oladunjoye Kayode, James W. Grice, András Telekes
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引用次数: 0

摘要

简介21基因分析(OncotypeDX)是针对pT1-3、pN0-1、激素受体(HR)阳性和人表皮生长因子受体-2(HER2)正常表达的乳腺癌(BC)的有效检测方法,可根据复发评分(RS)的计算来确定疾病的侵袭性:在这项回顾性研究中,作者通过传统统计方法和观察定向建模(OOM)方法,将病理特征和复发评分(RS)关联起来,研究了一批现实的乳腺癌患者:对90名BC患者的94个肿瘤标本进行了OncotypeDX检测。>83%的结节阴性(pN0)和>72%的结节阳性(pN1)病例可以避免化疗。对于 pN0 病例,非参数相关性和检验证明了八种特征(孕酮受体(PR)表达、Ki-67 值、Ki-67 组、PR 组、分级、雌激素受体(ER)表达、诺丁汉预后指数(NPI)和临床风险)之间的显著相关性。对于 pN1 病例,参数相关性和检验结果显示,六种特征类型(阳性结节数、ER 和 PR 表达、PR 组、Ki-67 组和 NPI)之间存在显著关联。根据 pN0 病例的 OOM,三种特征(Ki-67 组、分级和 NPI 组)之间存在显著关联。对于 pN1 病例,OOM 发现与七个特征(PR 组、PNI、LVI、Ki-67 组、分级、NPI 组和阳性结节数)有显著关联:与传统统计方法相比,OOM 首次应用于肿瘤学,发现了与 RS 相关的其他一些重要特征。有少数患者的特征与 RS 之间没有临床关联,这与统计学上的显著差异相反。因此,这些统计分析结果既不能应用于个别病例,也不能作为筛查患者(即是否需要进行 OncotypeDX 检测)的依据。OncotypeDX仍然是一种针对BC的个性化方法。
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Association between pathological characteristics and recurrence score by OncotypeDX in resected T1-3 and N0-1 breast cancer: a real-life experience of a North Hungarian regional center
Introduction: The 21-gene analysis (OncotypeDX) is validated test for pT1-3, pN0-1 with hormone receptor (HR) positive and normal expression of human epidermal growth factor receptor-2 (HER2) breast cancer (BC) to determine the aggressiveness of the disease based on the calculation of Recurrence Score (RS).Methods: In this retrospective study the authors correlated pathological characteristics and Recurrence Score (RS) by traditional statistical methods and Observed Oriented Modeling (OOM) in a realistic cohort of BC patients.Results: OncotypeDX tests were performed in 94 tumour specimens of 90 BC patients. >83% of node-negative (pN0) and >72% of node-positive (pN1) cases could avoid chemotherapy. For pN0 cases, non-parametric correlation and tests demonstrated significant association in eight types of characteristics [progesterone receptor (PR) expression, Ki-67 value, Ki-67 group, PR group, grade, estrogen receptor (ER) expression, Nottingham Prognostic Index (NPI) and Clinical Risk]. For pN1 cases, parametric correlation and tests showed significant association in six characteristic types (number of positive nodes, ER and PR expression, PR group, Ki-67 group and NPI). Based on OOM for pN0 cases, significant associations were established in three characteristics (Ki-67 group, grade and NPI group). For pN1 cases OOM found significant associations in seven characteristics (PR group, PNI, LVI, Ki-67 group, grade, NPI group and number of positive nodes).Conclusion: First in oncology, OOM was applied, which found some other significant characteristics associated with RS than traditional statistical methods. There were few patients, where no clinical associations were found between characteristics and RS contrary to statistically significant differences. Therefore, the results of these statistical analyses can be neither applied for individual cases nor able to provide the bases for screening patients, i.e., whether they need for OncotypeDX testing or not. OncotypeDX still provides a personalised approach in BC.
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