Effects of BRCA1/2 on Ovarian and Breast Cancer Survival--Response.
Effects of BRCA1/2 on Ovarian and Breast Cancer Survival--Response.
复制标题
BRCA1/2 对卵巢癌和乳腺癌生存的影响——反应。
DOI：
10.1158/1078-0432.ccr-15-0931
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Hwang,Wei-Ting
中科院分区：
文献类型：
--
作者：
Zhong,Qian;Peng,Hong-Ling;Zhao,Xia;Zhang,Lin;Hwang,Wei-Ting
关于第一点，我们想指出的是，使用风险比（HR）作为关联性的总体指标的一个优点是，HR与特定时间点（例如，5年或10年）无关，因为HR估计了两种潜在风险的真实比率，并且该比率被假设为随时间推移而保持不变。不同的随访持续时间可能会影响置信区间（CI）的宽度，这已经被考虑到合并HR的计算中。我们使用McLaughlin及其同事的10年HR估计值（3）而不是5年HR重复了荟萃分析，获得了几乎相同的结果。荟萃分析不要求研究具有可比性的随访。我们认为，我们的联合HR作为关联的总体指标仍然有效。关于第二点，Boyd及其同事（4）报告的P值0.008是基于对数秩（Cox-Mantel）检验，因此理论上，如果潜在的风险函数彼此不完全成比例，则它们的结果可能与通过考克斯PH模型估计的结果不同，如图2（4）所示。如果有足够数量的受试者和事件，并且观察间隔足够（5），则通过阅读KM曲线直接估计HR的技术性能良好，例如在该研究中。
Regarding the first point, we want to point out one advantage of using hazard ratio (HR) as an overall measure of association is that HR is irrelevant to a specific time point (eg, 5 or 10 years), because HR estimates the true ratio of two underlying hazards and the ratio is assumed to be constant over time. Varying follow-up durations may potentially influence the width of the confidence interval (CI), which is already factored into the calculation of the combined HR. We had repeated the meta-analysis using the 10-year HR estimate from McLaughlin and colleagues (3) instead of the 5-year HR and obtained almost identical results. Meta-analysis does not require studies to have comparable follow-up. We believe that our combined HR as an overall measure of association remains valid.Regarding the second point, the P value of 0.008 reported in Boyd and colleagues (4) was based on a log-rank (Cox–Mantel) test, so theoretically their results could be different from results estimated by a Cox PH model if the underlying hazard functions are not entirely proportional to each other, as suggested by Fig. 2 (4). The technique of estimating HR by reading KM curve directly performs well if there are a sufficient number of subjects and events and if the observation intervals are adequate (5), such as in that study.