■OncotypeDX乳房复发评分®测试(ODx)是一种基因谱分析测定,可预测辅助化疗对早期激素受体(HR)阳性和人表皮生长因子受体2(HER2)阴性乳腺癌的益处。同时,为了避免病人不必要的经济负担,许多研究试图建立替代ODx使用传统的临床病理因素,但是这些还没有成功。因此,我们回顾性调查了临床病理因素以建立ODx的替代方法.
■对114名接受ODx的日本妇女的数据进行回顾性检查,以研究ODx复发评分(RS)与临床病理特征之间的关系,包括免疫组织化学评估的MUC1染色模式。0-25的RS被定义为低,和26-100一样高。
■90例患者(79%)具有低RS,24例患者(21%)具有高RS。单因素分析显示肿瘤分级低,孕激素受体(PgR)高表达,和低Ki67标记指数(LI)与低RS显著相关(分别为p=0.025,p<0.001和p<0.001)。具有MUC1染色顶端模式的肿瘤也经常具有低RS(p=0.024)。在多变量分析中,PgR表达和Ki67LI是与RS相关的独立因素(两者p<0.001)。当ODx结果与这两个因素的组合进行分类时,PgR高组和Ki67低组(51例中的1例)中只有2%具有高RS。
■PgR表达和Ki67LI是与RS相关的独立因素。MUC1染色模式也有可能成为有用的标记物。我们认为,继续尝试确定不太可能从ODx中受益的患者至关重要。
UNASSIGNED: Oncotype DX Breast Recurrence Score® test (ODx) is a gene profiling assay predicting the benefit of adjuvant chemotherapy for early-stage hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Meanwhile, to avoid unnecessary financial burden on the patient, many studies have attempted to establish alternatives to ODx using conventional clinicopathological factors, but these have not yet been successful. Thus, we retrospectively investigated clinicopathological factors to establish alternatives to ODx.
UNASSIGNED: Data from 114 Japanese women who underwent ODx were retrospectively examined to investigate the relationship between ODx recurrence score (RS) and clinicopathological features, including MUC1 staining patterns on immunohistochemical assessment. An RS of 0-25 was defined as low, and 26-100 as high.
UNASSIGNED: Ninety patients (79%) had low RS and 24 patients (21%) had high RS. Univariate analysis revealed that low tumor grade, high progesterone receptor (PgR) expression, and low Ki67 labeling index (LI) were significantly associated with low RS (p=0.025, p<0.001, and p<0.001, respectively). Tumors with an apical pattern of MUC1 staining also frequently had a low RS (p=0.024). In multivariate analysis, PgR expression and Ki67 LI were independent factors associated with RS (p<0.001, for both). When the ODx results were categorized with a combination of these two factors, only 2% of the PgR-high and Ki67-low group (one in 51 cases) had a high RS.
UNASSIGNED: PgR expression and Ki67 LI were independent factors correlated with RS. MUC1 staining pattern also has the potential to be a useful marker. We believe that it is crucial to continue attempts to identify patients who are unlikely to benefit from ODx.