乳腺癌年轻和黑人女性21基因和PAM50复发得分的差异
Sarah C Van Alsten1,2, Sanah N Vohra1,2, Joannie M Ivory3
1Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
JCO precision oncology
|July 16, 2024
概括
两项用于乳腺癌预后的基因组测试在不同人群中显示出不同的结果. 在预测复发风险方面,Prosigna复发风险 (ROR-P) 试验的表现优于21基因复发得分 (RS).
科学领域:
- 基因组医学是一种基因组医学.
- 乳腺癌研究研究 乳腺癌研究
- 在瘤学瘤学.
背景情况:
- 基因组测试,如瘤型Dx21基因 (RS) 和Prosigna复发风险 (ROR-P) 测试,对于乳腺癌预后至关重要.
- 新出现的数据表明测试的可变性,需要在不同人群中进行比较.
研究的目的:
- 为了比较两个基于RNA的预后测试ROR-P和21基因复发分数 (RS) 的表现,在多样化的群体中.
- 调查这些测定与种族和年龄在乳腺癌预后中的关联.
主要方法:
- 来自卡罗来纳州乳腺癌研究的647个I-III阶段ER+/HER2-瘤的RNA测序,过量采样黑人和年轻女性.
- 使用了ROR-P (ROR-PR) 和21基因复发评分 (RSR) 的研究版本.
- 分析了与种族和年龄的关联,并使用考克斯回归来建模复发风险,检查增殖和雌激素模块得分.
主要成果:
- 黑人女性的ROR-PR得分 (中等/高) 比非黑人女性高;RSR没有显著的种族关联.
- ROR-PR得分与复发风险相关 (HR 4.67为高,2.12为中等),而RSR没有预测复发.
- ROR-PR强调增殖,RSR强调雌激素;较高的增殖得分与年轻和黑人种族有关. 对RSR的修改改善了预后.
结论:
- ROR-PR和RSR不同突出雌激素和增殖途径.
- 21基因RS对雌激素的强调和黑人女性的下分泌治疗使用可能会损害其在不同人群中的预后能力.
- 修改RS算法以强调扩散,提高了它在这个群体中的效用.
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