Clinical value of prognosis gene expression signatures in colorectal cancer: a systematic review.
Clinical value of prognosis gene expression signatures in colorectal cancer: a systematic review.
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DOI：
10.1371/journal.pone.0048877
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Moreno V
中科院分区：
文献类型：
--
作者：
Sanz-Pamplona R;Berenguer A;Cordero D;Riccadonna S;Solé X;Crous-Bou M;Guinó E;Sanjuan X;Biondo S;Soriano A;Jurman G;Capella G;Furlanello C;Moreno V
传统的分期系统不足以识别那些具有高复发风险的II期结直肠癌（CRC）或具有低复发风险的III期结直肠癌的患者。已经提出了许多预测CRC预后的基因表达特征，但没有一个在临床上常规使用。这项工作的目的是评估这些签名在一系列独立数据集中的预测能力和潜在临床有用性。一项文献综述确定了31个基因表达特征，这些基因表达特征使用基因表达数据来预测CRC组织的预后。检索基于PubMed数据库，仅限于2004年1月至2011年12月发表的论文。11个CRC基因表达数据集与结果信息进行了鉴定，并从公共资料库下载。随机森林分类器用于从基因列表中构建预测因子。选择马修斯相关系数作为分类准确性的衡量标准，其相关p值用于评估与预后的相关性。对于临床有效性评价，计算了II期和III期样本的阳性和阴性后检验概率。五个基因特征显示出与预后的显著相关性，并在自己的训练数据集中提供了合理的预测准确性。然而，所有的签名在独立数据中显示出低再现性。按分期或微卫星不稳定性状态进行的分层分析显示出显著的相关性，但区分能力有限，尤其是在II期肿瘤中。从临床的角度来看，最具预测性的签名显示出比经典分期系统小但显著的改善。已发表的特征显示预测准确性较低，但临床实用性中等。虽然基因表达数据可以告知预后，但需要更好的签名验证策略来鼓励其在临床中的广泛使用。
The traditional staging system is inadequate to identify those patients with stage II colorectal cancer (CRC) at high risk of recurrence or with stage III CRC at low risk. A number of gene expression signatures to predict CRC prognosis have been proposed, but none is routinely used in the clinic. The aim of this work was to assess the prediction ability and potential clinical usefulness of these signatures in a series of independent datasets. A literature review identified 31 gene expression signatures that used gene expression data to predict prognosis in CRC tissue. The search was based on the PubMed database and was restricted to papers published from January 2004 to December 2011. Eleven CRC gene expression datasets with outcome information were identified and downloaded from public repositories. Random Forest classifier was used to build predictors from the gene lists. Matthews correlation coefficient was chosen as a measure of classification accuracy and its associated p-value was used to assess association with prognosis. For clinical usefulness evaluation, positive and negative post-tests probabilities were computed in stage II and III samples. Five gene signatures showed significant association with prognosis and provided reasonable prediction accuracy in their own training datasets. Nevertheless, all signatures showed low reproducibility in independent data. Stratified analyses by stage or microsatellite instability status showed significant association but limited discrimination ability, especially in stage II tumors. From a clinical perspective, the most predictive signatures showed a minor but significant improvement over the classical staging system. The published signatures show low prediction accuracy but moderate clinical usefulness. Although gene expression data may inform prognosis, better strategies for signature validation are needed to encourage their widespread use in the clinic.
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影响因子：
8.8
作者：
Anjomshoaa, A.;Lin, Y-H;Black, M. A.;McCall, J. L.;Humar, B.;Song, S.;Fukuzawa, R.;Yoon, H. -S;Holzmann, B.;Friederichs, J.;Van Rij, A.;Thompson-Fawcett, M.;Reeve, A. E.
通讯作者：
Reeve, A. E.
影响因子：
3
作者：
Díaz-Uriarte R;Alvarez de Andrés S
通讯作者：
Alvarez de Andrés S
影响因子：
45.3
作者：
Eschrich, S;Yang, I;Yeatman, TJ
通讯作者：
Yeatman, TJ
影响因子：
8.8
作者：
Andersen, C. L.;Christensen, L. L.;Thorsen, K.;Schepeler, T.;Sorensen, F. B.;Verspaget, H. W.;Simon, R.;Kruhoffer, M.;Aaltonen, L. A.;Laurberg, S.;Orntoft, T. F.
通讯作者：
Orntoft, T. F.
影响因子：
4
作者：
Dotan E;Cohen SJ
通讯作者：
Cohen SJ