Molecular subtypes predict second breast events of ductal carcinoma in situ after breast-conserving surgery.
Molecular subtypes predict second breast events of ductal carcinoma in situ after breast-conserving surgery.
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分子亚型预测保乳手术后导管内癌的第二次乳房事件
DOI：
10.1002/cam4.4651
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发表时间：
2022-07
期刊：
影响因子：
4
通讯作者：
Yu, Xiaoli
中科院分区：
文献类型：
--
作者：
Yang, Yilan;Zhao, Xu;Wang, Xuanyi;Jin, Kairui;Luo, Jurui;Yang, Zhaozhi;Mei, Xin;Ma, Jinli;Shao, Zhimin;Zhang, Zhen;Chen, Xingxing;Guo, Xiaomao;Yu, Xiaoli
目前，分子亚型在导管原位癌（DCIS）中的预后价值仍不清楚。在这项研究中，我们探讨了分子亚型是否可以预测保乳手术（BCS）后患者的第二次乳房事件（SBE）。回顾性分析了2008年1月至2016年12月期间接受BCS治疗的291例DCIS患者。患者分为四种分子亚型：管腔A型、管腔B型、人表皮生长因子受体2（HER 2）过表达和三阴性乳腺癌（TNBC）。采用竞争风险模型计算SBE发生率，并采用Gray检验进行比较。采用Kaplan-Meier法估计无病生存率，并采用对数秩检验进行比较。采用单因素和多因素考克斯比例风险回归模型分析影响预后的因素。中位随访时间为66个月，确定了12例SBE。管腔A、管腔B、HER 2过表达和TNBC的5年总体SBE发生率分别为2.18%、4.25%、15.15%和0.00%。在单变量分析中，HER 2过表达亚型是总体（p = 0.005）、原位（p = 0.004）和同侧SBE（p = 0.008）的预测因子。内分泌治疗的患者不太可能发生原位SBE（p = 0.039）。此外，边缘闭合（<2 mm）或受累的患者与对侧SBE的风险较高相关（p = 0.029）。在多变量分析中，HER 2过表达亚型仍然具有总体（p = 0.006）、原位（p = 0.029）和同侧SBE（p = 0.012）的预后价值。分子亚型，尤其是HER 2过表达亚型，是DCIS患者接受BCS的独立预后因素。
Currently, the prognostic value of molecular subtypes in ductal carcinoma in situ (DCIS) remains unclear. In this study, we explored whether molecular subtypes could predict second breast events (SBEs) in patients after breast‐conserving surgery (BCS). From January 2008 to December 2016, 291 DCIS patients treated with BCS were retrospectively analyzed. Patients were classified into four molecular subtypes: luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) overexpression, and triple‐negative breast cancer (TNBC). The SBE incidence was calculated by the competing risk model and compared by Gray's test. The disease‐free survival rates were estimated by the Kaplan–Meier method and compared by the log‐rank test. Prognostic factors were evaluated by univariate and multivariate COX proportional hazards regression model. With a median follow‐up of 66 months, 12 SBEs were identified. The 5‐year overall SBE incidence of luminal A, luminal B, HER2 overexpression, and TNBC was 2.18%, 4.25%, 15.15%, and 0.00%, respectively. In the univariate analysis, the HER2 overexpression subtype was the predictor of overall (p = 0.005), in situ (p = 0.004), and ipsilateral SBEs (p = 0.008). Patients with endocrine therapy were less likely to develop in situ SBEs (p = 0.039). Additionally, patients with closed (<2 mm) or involved margins were related to a higher risk of contralateral SBEs (p = 0.029). In the multivariate analysis, the HER2 overexpression subtype remained of prognostic values for overall (p = 0.006), in situ (p = 0.029), and ipsilateral SBEs (p = 0.012). The molecular subtype, especially the HER2 overexpression subtype, was the independent prognostic factor for DCIS patients who underwent BCS.
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一种多基因表达测定法，以预测乳房原位导管癌的局部复发风险。
DOI：
10.1093/jnci/djt067
发表时间：
2013-05-15
期刊：
Journal of the National Cancer Institute
影响因子：
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DOI：
10.1093/jncimonographs/lgq021
发表时间：
2010-01-01
期刊：
Journal of the National Cancer Institute Monographs
影响因子：
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