A gene-expression signature as a predictor of survival in breast cancer.
A gene-expression signature as a predictor of survival in breast cancer.
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DOI：
10.1056/nejmoa021967
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发表时间：
2002-12-19
影响因子：
158.5
通讯作者：
Bernards, R
中科院分区：
文献类型：
--
作者：
van de Vijver, MJ;He, YD;Bernards, R
背景资料：一个更准确的手段，在乳腺癌的precentication将提高选择患者的辅助全身therapy.Methods：使用微阵列分析，以评估我们以前建立的70个基因的预后概况，我们分类为一系列的295例原发性乳腺癌的基因表达的签名与预后不良或预后良好。所有患者均为I期或II期乳腺癌，年龄小于53岁; 151例淋巴结阴性疾病，144例淋巴结阳性疾病。结果：在295名患者中，180名患者预后不良，115名患者预后良好，10年生存率分别为54.6+/-4.4%和94.5+/-2.6%。10年时，预后不良组中保持无远处转移的概率为50.6+/-4.5%，预后良好组为85.2+/-4.3%。与预后良好组相比，预后不良组发生远处转移的估计风险比为5.1（95%置信区间为2.9 - 9.0; P
Background: A more accurate means of prognostication in breast cancer will improve the selection of patients for adjuvant systemic therapy.Methods: Using microarray analysis to evaluate our previously established 70-gene prognosis profile, we classified a series of 295 consecutive patients with primary breast carcinomas as having a gene-expression signature associated with either a poor prognosis or a good prognosis. All patients had stage I or II breast cancer and were younger than 53 years old; 151 had lymph-node-negative disease, and 144 had lymph-node-positive disease. We evaluated the predictive power of the prognosis profile using univariable and multivariable statistical analyses.Results: Among the 295 patients, 180 had a poor-prognosis signature and 115 had a good-prognosis signature, and the mean (+/-SE) overall 10-year survival rates were 54.6+/-4.4 percent and 94.5+/-2.6 percent, respectively. At 10 years, the probability of remaining free of distant metastases was 50.6+/-4.5 percent in the group with a poor-prognosis signature and 85.2+/-4.3 percent in the group with a good-prognosis signature. The estimated hazard ratio for distant metastases in the group with a poor-prognosis signature, as compared with the group with the good-prognosis signature, was 5.1 (95 percent confidence interval, 2.9 to 9.0; P