一个简化的风险评分系统,用于预测高风险群体的基因表达测试对患者的雌激素受体阳性,人体表皮生长因子受体2-阴性和节点阳性乳腺癌
Kwang Hyun Yoon1,2, Suk Jun Lee3, Yujin Kim3
1Department of Surgery, Gangneung Asan Medical Center, Gangneung, Korea.
Annals of surgical treatment and research
|December 11, 2023
概括
基因表达试验 (GET) 可以预测结节阳性乳腺癌的化疗反应和复发风险. 传统因素,如瘤大小和等级可以预测高风险的GET结果,帮助治疗决策.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 基因表达试验 (GET) 有助于预测乳腺癌患者的化疗反应和复发风险.
- 随机试验表明,一些节点阳性患者从避免辅助化疗中受益.
- 准确的风险分层对于个性化乳腺癌治疗至关重要.
研究的目的:
- 为了预测型DX和MammaPrint基因表达测试的结果.
- 评估传统临床病理学因素在预测GET结果中的有用性.
- 为了确定患有激素受体阳性/人表皮生长因子受体2-阴性,结节阳性乳腺癌的患者,他们可能不会从GET测定中受益.
主要方法:
- 对311名结节阳性,HR+/HER2-原发性侵袭性乳腺癌患者的回顾性审查.
- 分析临床病理学变量,包括瘤大小,孕激素受体状态,组织学等级,HER2状态和Ki-67水平.
- 单变量和多变量逻辑回归用于评估变量之间的关系和GET风险分层.
主要成果:
- 开发了一个评分系统,使用组织学等级,瘤大小,孕激素受体状态,HER2状态和Ki-67水平.
- 该评分系统在验证队列中实现了0.798 (95% CI,0.744-0.844) 的整体准确性.
- 使用这些传统的临床病理学因素,高GET风险结果是可以预测的.
结论:
- 传统的临床病理学因素可以有效地预测基因表达试验的高风险结果.
- 这些发现支持HR+/HER2-节点阳性乳腺癌患者的知情治疗决策.
- 这种方法可以帮助识别那些GET测定可能不太适用或不必要的患者.
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