Gene Expression Profiling for Breast Cancer Prognosis in Chinese Populations
Gene Expression Profiling for Breast Cancer Prognosis in Chinese Populations
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DOI：
10.1111/j.1524-4741.2010.01049.x
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发表时间：
2011-03-01
期刊：
影响因子：
2.1
通讯作者：
Song, San-tai
中科院分区：
文献类型：
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作者：
Sun, Bing;Zhang, Feng;Song, San-tai
目的探讨一种不同于21基因检测的定量逆转录聚合酶链式反应(QRT-PCR)方法，用于预测雌激素受体(ER)阳性、淋巴结(LN)阴性乳腺癌患者的复发风险。目的：通过对中国LN阴性和阳性乳腺癌患者石蜡组织的分析，准确地确定我们的方法得出的复发评分(RS)与远处复发风险之间的关系。我们从浸润性乳腺癌和不同腋窝淋巴结受累的患者身上获得石蜡包埋的档案组织。采用SYBR Green I带引物染色的方法进行QRT-PCR反应。通过预先指定的算法将21个基因的表达转换为RS。然后，我们评估了这项测试在这个回溯性队列中准确预测远程无复发生存率的可能性。根据基因表达谱，93名患者符合条件。在我们的人群中，大多数乳腺癌患者是绝经前(82.6%)、早期(93.6%)和ER阳性(91.4%)。中位随访期为65.9个月。5年无复发生存率为58.8%。逆转录-聚合酶链式反应和免疫组织化学(IHC)法检测ER、孕激素受体(PGR)和HER-2的符合率较高，具有可比性。高RS预示着复发风险的增加(p<；0.001)。在亚组患者中，RS对结节阴性患者(p=0.009)和结节阳性患者(p=0.038)均有显著的预测作用。多因素分析显示，淋巴结状态、辅助激素治疗和RS与预后显著相关。RS分类是一种比其他风险评估标准或临床病理特征更好的预测因子，可以更准确地确定各种患者的复发风险。我们已经建立了一种简单、经济的QRT-PCR方法，并与IHC对ER、PGR和HER-2的测量结果一致。在激素受体(HR)阳性的中国乳腺癌患者中，RS与远处复发相关。这项研究可能会促进从21个基因集的表达估计的RS在中国人群中用于预测和常规临床诊断应用。
To investigate a quantitative reverse transcription polymerase chain reaction (QRT-PCR) assay different from 21-gene assay which can be used to prognosticate the risk of recurrence in patients with estrogen receptor (ER) positive, lymph node (LN) negative breast cancer. To accurately determine the relationship between the Recurrence Score (RS) derived from our assay and the risk of distant recurrence in Chinese patients with LN negative and positive breast cancer through the analysis of paraffin tissues. We obtained archival paraffin-embedded tissues from patients with invasive breast cancer and varying axillary lymph node involvement. QRT-PCR reaction was performed by using the method of SYBR Green I dye with primers. Expression of the 21-genes was converted to RS by a prespecified algorithm. We then assessed the probability of the test to accurately predict distant recurrence-free survival in this retrospective cohort. Ninety-three patients were eligible based on gene expression profiles. In our population, most breast cancer patients were premenopausal (82.6%), at early stage (93.6%) and ER positive (91.4%). Median follow-up was 65.9 months. The 5-year recurrence-free survival rate for the group was 58.8%. The concordance between the reverse transcription-PCR and immunohistochemical (IHC) measurement for ER, progesterone receptor (PgR), and HER-2 determinations was high and comparable. High RS was predictive of an elevated risk of relapse (p < 0.001). In subgroups of patients, RS had significantly predictive performance both in node-negative (p = 0.009) and node-positive patients (p = 0.038). Multivariable analysis showed that nodal status, adjuvant hormonal therapy and RS were significantly related to prognosis. RS category is a better predictor than the other risk assessment criteria or clinicopatholic features, with which we can determine more accurately the risks for recurrence of various patients. We have established an easy and economical QRT-PCR assay and validated in concordance with IHC measurements for ER, PgR, and HER-2. RS was associated with distant recurrence among Chinese patients with hormone receptor (HR) positive breast cancer. This study may promote the use of RS estimated from the expression of the 21-gene set for prognostication and routine clinical diagnostic application in Chinese populations.