Routine pathologic parameters can predict Oncotype DXTM recurrence scores in subsets of ER positive patients: who does not always need testing?
Routine pathologic parameters can predict Oncotype DXTM recurrence scores in subsets of ER positive patients: who does not always need testing?
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DOI：
10.1007/s10549-011-1416-3
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发表时间：
2012-01-01
影响因子：
3.8
通讯作者：
Gown, A. M.
中科院分区：
文献类型：
--
作者：
Allison, K. H.;Kandalaft, P. L.;Gown, A. M.
Oncotype DXTM是一种基于RT-PCR的检测方法，用于预测雌激素受体（ER）阳性乳腺癌患者的化疗获益。我们感兴趣的是，常规可用的病理参数是否可以预测患者亚组中的Oncotype DXTM复发评分（RS）。我们确定了173例具有可用RS的乳腺癌，并将其中104例用作测试集，69例用作验证集。病理学特征包括肿瘤大小、组织学类型、诺丁汉分级和淋巴管浸润。对测试集病例进行ER、孕酮受体（PR）、HER 2、Ki 67、CyclinD 1、BCL 2、D2-40和P53染色。用RS和回归树分析进行统计相关。根据等级、PR和Ki 67对验证集进行分析。在测试集中，等级、PR水平和Ki 67与RS的相关性最强（P = 0.0002-0.0007）。回归树分析表明，等级和PR作为因素，可以隔离的情况下，RS类别，与Ki 67添加值在某些子集。具有低RS（0-18）的高可能性的癌症子集被鉴定为具有以下特征：1级、强PR表达（Allred评分为千分之一日元5）和Ki 67千分之一货币符号10%。具有这些特征的病例均没有高RS（千分之一日元31），73%的病例具有低RS。极有可能具有高RS的癌症为3级，PR表达低至不存在（Allred评分< 5）且Ki 67> 10%。具有这些特征的病例中，80%的病例具有高RS，没有病例具有低RS。我们的验证集在这两个子集中有相似的发现。总之，当成本和时间是一个考虑因素和Oncotype DXTM测试的附加值是有问题的，它可能是合理的，假设该测试的结果在两个特定的乳腺癌子集：（1）1级，高PR，低Ki 67癌症（低RS），和（2）3级，低PR，高Ki 67癌症（高RS）。
Oncotype DXTM is an RT-PCR-based assay used to predict chemotherapy benefit in patients with estrogen receptor (ER) positive breast cancers. We were interested if routinely available pathologic parameters could predict Oncotype DXTM Recurrence Scores (RS) in subsets of patients. We identified 173 breast cancers with available RSs and used 104 of these as a test set and 69 cases as a validation set. Pathologic characteristics including size, histologic type, Nottingham grade, and lymphatic invasion were recorded. Test set cases were stained for ER, progesterone receptor (PR), HER2, Ki67, CyclinD1, BCL2, D2-40, and P53. Statistical correlations with RS and regression tree analysis were performed. The validation set was subjected to analysis on the basis of grade, PR, and Ki67. In the test set, grade, PR levels and Ki67 had the strongest correlation with RS (P = 0.0002-0.0007). Regression tree analysis showed grade and PR as factors that could segregate cases into RS categories, with Ki67 adding value in certain subsets. A subset of cancers with a high likelihood of having a low RS (0-18) was identified with the following characteristics: grade 1, strong PR expression (Allred score a parts per thousand yen5) and Ki67 a parts per thousand currency sign 10%. No cases with these characteristics had a high RS (a parts per thousand yen31) and 73% had a low RS. Cancers highly likely to have a high RS were grade 3, low to absent PR expression (Allred score < 5) and Ki67 > 10%. 80% of cases with these characteristics had a high RS and no cases had a low RS. Our validation set had similar findings in these two subsets. In conclusion, When cost and time are a consideration and the added value of Oncotype DXTM testing is in question, it may be reasonable to assume the results of this test in two specific subsets of breast cancers: (1) grade 1, high PR, low Ki67 cancers (low RS), and (2) grade 3, low PR, high Ki67 cancers (high RS).