Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis.
Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis.
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DOI：
10.1038/modpathol.2013.36
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发表时间：
2013-05
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Oncotype DX是一种商业检测方法，经常用于雌激素受体（ER）阳性乳腺癌的化疗决策。结果以复发评分报告，评分范围从0到100，分为低危（<18）、中危（18 - 30）和高危（≥31）三类。我们的初步研究表明，复发评分可以通过包含标准形态免疫组织学变量的方程（称为原始Magee方程）来预测。使用817个病例的数据集，我们制定了三个额外的方程（称为新Magee方程1、2和3）来预测255个病例的独立集的递归评分类别。原Magee方程、新Magee方程1、2和3的Oncotype DX风险类别与我们的方程的一致性分别为54.3%、55.8%、59.4%和54.4%。排除中间类别后，原Magee方程、新Magee方程1、2和3的一致性分别提高到96.9%、100%、98.6%和98.7%。即使估计的递归分数在任何一个方程中处于中间类别，在超过80%的情况下，实际的递归分数不是中等就是低。这四个方程中的任何一个都可以用来根据可用数据估计递归得分。如果估计的复发评分明显高或低，肿瘤学家不应该期望与Oncotype DX有显著不同的结果，并且可能不需要Oncotype DX测试。相反，Oncotype DX结果与基于标准形态免疫组织学变量的预期结果显著不同，则应彻底调查。
Oncotype DX is a commercial assay frequently used for making chemotherapy decisions in estrogen receptor (ER)-positive breast cancers. The result is reported as a recurrence score ranging from 0 to 100, divided into low-risk (<18), intermediate-risk (18–30), and high-risk (≥31) categories. Our pilot study showed that recurrence score can be predicted by an equation incorporating standard morphoimmunohistologic variables (referred to as original Magee equation). Using a data set of 817 cases, we formulated three additional equations (referred to as new Magee equations 1, 2, and 3) to predict the recurrence score category for an independent set of 255 cases. The concordance between the risk category of Oncotype DX and our equations was 54.3%, 55.8%, 59.4%, and 54.4% for original Magee equation, new Magee equations 1, 2, and 3, respectively. When the intermediate category was eliminated, the concordance increased to 96.9%, 100%, 98.6%, and 98.7% for original Magee equation, new Magee equations 1, 2, and 3, respectively. Even when the estimated recurrence score fell in the intermediate category with any of the equations, the actual recurrence score was either intermediate or low in more than 80% of the cases. Any of the four equations can be used to estimate the recurrence score depending on available data. If the estimated recurrence score is clearly high or low, the oncologists should not expect a dramatically different result from Oncotype DX, and the Oncotype DX test may not be needed. Conversely, an Oncotype DX result that is dramatically different from what is expected based on standard morphoimmunohistologic variables should be thoroughly investigated.
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