Abstract:
(1) Background: Chromatin structure typing has been used for prognostic risk stratification among cancer survivors. This study aimed to ascertain the prognostic values of ploidy, nucleotyping, and tumor-stroma ratio (TSR) in predicting disease progression for patients with early-stage non-small cell lung cancer (NSCLC), and to explore whether patients with different nucleotyping profiles can benefit from adjuvant chemotherapy. (2) Methods: DNA ploidy, nucleotyping, and TSR were measured by chromatin structure typing analysis (Matrix Analyser, Room4, Kent, UK). Cox proportional hazard regression models were used to assess the relationships of DNA ploidy, nucleotyping, and TSR with a 5-year disease-free survival (DFS). (3) Results: among 154 early-stage NSCLC patients, 102 were non-diploid, 40 had chromatin heterogeneity, and 126 had a low stroma fraction, respectively. Univariable analysis suggested that non-diploidy was associated with a significantly lower 5-year DFS rate. After combining DNA ploidy and nucleotyping for risk stratification and adjusting for potential confounders, the DNA ploidy and nucleotyping (PN) high-risk group and PN medium-risk group had a 4- (95% CI: 1.497-8.754) and 3-fold (95% CI: 1.196-6.380) increase in the risk of disease progression or mortality within 5 years of follow-up, respectively, compared to the PN low-risk group. In PN high-risk patients, adjuvant therapy was associated with a significantly improved 5-year DFS (HR = 0.214, 95% CI: 0.048-0.957, p = 0.027). (4) Conclusions: the non-diploid DNA status and the combination of ploidy and nucleotyping can be useful prognostic indicators to predict long-term outcomes in early-stage NSCLC patients. Additionally, NSCLC patients with non-diploidy and chromatin homogenous status may benefit from adjuvant therapy.
摘要:
(1)背景:染色质结构分型已用于癌症幸存者的预后风险分层。本研究旨在确定倍性的预后价值,核型,和肿瘤基质比(TSR)预测早期非小细胞肺癌(NSCLC)患者的疾病进展,并探讨不同核型的患者是否可以从辅助化疗中获益。(2)方法:DNA倍性,核型,和TSR通过染色质结构分型分析(矩阵分析仪,肯特4号房间,英国)。Cox比例风险回归模型用于评估DNA倍性的关系,核型,和TSR,5年无病生存期(DFS)。(3)结果:154例早期非小细胞肺癌患者中,102是非二倍体,40具有染色质异质性,126的基质分数很低,分别。单变量分析表明,非二倍体与5年DFS率显着降低有关。在结合DNA倍性和核型分析进行风险分层和调整潜在的混杂因素后,DNA倍性和核型(PN)高危组和中危组的4-(95%CI:1.497-8.754)和3倍(95%CI:1.196-6.380)的风险增加5年内的疾病进展或死亡,分别,与PN低风险组相比。在PN高危患者中,辅助治疗与显著改善的5年DFS相关(HR=0.214,95%CI:0.048~0.957,p=0.027).(4)结论:非二倍体DNA状态以及倍体和核型的结合可以作为预测早期NSCLC患者长期预后的有用指标。此外,非二倍体和染色质同质状态的NSCLC患者可能受益于辅助治疗。