Copy Number Imbalances between Screen- and Symptom-Detected Breast Cancers and Impact on Disease-Free Survival
Copy Number Imbalances between Screen- and Symptom-Detected Breast Cancers and Impact on Disease-Free Survival
复制标题
DOI：
10.1158/1940-6207.capr-10-0361
复制
发表时间：
2011-10-01
影响因子：
3.3
通讯作者：
Bondy, M.
中科院分区：
文献类型：
--
作者：
Brewster, A. M.;Thompson, P.;Bondy, M.
筛查乳房X光检查可以增加惰性肿瘤的检出率。我们假设筛查和症状检测到的肿瘤会显示出拷贝数不平衡（CNI）的基因型差异，这在一定程度上解释了筛查和症状检测到的乳腺肿瘤之间临床行为的差异。我们评估了 1985 年至 2000 年间在德克萨斯大学 MD 安德森癌症中心诊断为 I 期和 II 期乳腺癌的 850 名 40 岁及以上女性，并提供了肿瘤检测方法（筛查与症状）的信息。使用高密度分子倒置探针阵列识别筛查和症状检测肿瘤中的 CNI。 Cox 比例模型用于评估调整年龄、分期和 CNI 后肿瘤检测方法对无病生存率的影响。与筛查检测到的肿瘤 (n = 247) 相比，大多数肿瘤是通过症状检测到的 (n = 603)。染色体 2p、3q、8q、11p 和 20q 的拷贝数增加与乳腺癌检测方法相关（P < 0.00001）。我们估计，在 50 至 70 岁和 40 至 87 岁的女性中，年龄、分期、核分级和 Ki67 分别占筛查检测生存优势的 32% 和 63%。在每个年龄组中，与检测方法相关的 CNI 占额外 20% 的生存优势。筛查检测到的肿瘤和症状检测到的肿瘤之间的特定 CNI 有所不同，这解释了与筛查检测到的肿瘤相关的部分生存优势。肿瘤基因型的测量有可能改善筛查检测到的惰性肿瘤和侵袭性肿瘤之间的区别，并帮助患者和医生做出有关使用手术和辅助治疗的决策。癌症预防研究； 4（10）； 1609-16。 (C)2011 AACR。
Screening mammography results in the increased detection of indolent tumors. We hypothesized that screen-and symptom-detected tumors would show genotypic differences as copy number imbalances (CNI) that, in part, explain differences in the clinical behavior between screen-and symptom-detected breast tumors. We evaluated 850 women aged 40 and above diagnosed with stage I and II breast cancer at the University of Texas MD Anderson Cancer Center between 1985 and 2000 with information available on method of tumor detection (screen vs. symptoms). CNIs in screen-and symptom-detected tumors were identified using high-density molecular inversion probe arrays. Cox proportional modeling was used to estimate the effect of method of tumor detection on disease-free survival after adjusting for age, stage, and the CNIs. The majority of tumors were symptom detected (n = 603) compared with screen detected (n 247). Copy number gains in chromosomes 2p, 3q, 8q, 11p, and 20q were associated with method of breast cancer detection (P < 0.00001). We estimated that 32% and 63% of the survival advantage of screen detection was accounted for by age, stage, nuclear grade, and Ki67 in women aged 50 to 70 and aged 40 to 87, respectively. In each age category, an additional 20% of the survival advantage was accounted for by CNIs associated with method of detection. Specific CNIs differ between screen- and symptom-detected tumors and explain part of the survival advantage associated with screen-detected tumors. Measurement of tumor genotype has the potential to improve discrimination between indolent and aggressive screen-detected tumors and aids patient and physician decision making about use of surgical and adjuvant treatments. Cancer Prev Res; 4(10); 1609-16. (C)2011 AACR.