Wolf Ido, Ben-Baruch Noa, Shapira-Frommer Ronnie, Rizel Shulamit, Goldberg Hadassa, Yaal-Hahoshen Neora, Klein Baruch, Geffen David B, Kaufman Bella
The Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.
Cancer. 2008 Feb 15;112(4):731-6. doi: 10.1002/cncr.23225.
The 21-gene recurrence score (RS) assay has been reported to accurately predict the risk of disease recurrence and chemotherapy benefit in women with estrogen receptor (ER)-positive, lymph node (LN)-negative breast cancer who are treated with tamoxifen. To the authors' knowledge, the association between the RS and clinicopathologic characteristics has been studied in randomized and case-control trials, but not in the general population.
The authors analyzed the correlation between clinicopathologic breast cancer characteristics and RS among 300 consecutive Israeli patients who were referred to undergo the test between October 2004 and October 2006.
Low, intermediate, and high RS were noted in 109 patients (36%), 134 patients (45%), and 57 patients (19%), respectively. The median age of the patients was 54 years and the median tumor size was 1.6 cm. High tumor grade, low progesterone receptor expression, infiltrating ductal histology, and high HER-2 expression were found to be associated with a high RS, whereas patient age, tumor size, ER expression, and lymph node micrometastasis were found to correlate poorly with the RS. The ability of any of these variables, either alone or in combination, to predict the RS was limited. Similarly, neither commonly used guidelines nor the Adjuvant! Online software were found to be able to predict the RS.
The results of the current study suggest that neither standard clinicopathologic features nor commonly used assessment tools can reliably predict the RS among referred breast cancer patients compared with a clinical trial population. These data also may indicate the need for additional studies regarding the role of the RS among certain subsets of breast cancer patients, including those with noninfiltrating ductal carcinoma histology and the presence of lymph node micrometastasis.
据报道，21基因复发评分（RS）检测可准确预测接受他莫昔芬治疗的雌激素受体（ER）阳性、淋巴结（LN）阴性乳腺癌女性患者的疾病复发风险和化疗获益情况。据作者所知，随机对照试验和病例对照试验研究了RS与临床病理特征之间的关联，但在一般人群中尚未进行此类研究。
作者分析了2004年10月至2006年10月期间连续转诊接受该检测的300例以色列患者的乳腺癌临床病理特征与RS之间的相关性。
分别有109例患者（36%）、134例患者（45%）和57例患者（19%）的RS为低、中、高。患者的中位年龄为54岁，中位肿瘤大小为1.6 cm。发现高肿瘤分级、低孕激素受体表达、浸润性导管组织学和高HER-2表达与高RS相关，而患者年龄、肿瘤大小、ER表达和淋巴结微转移与RS的相关性较差。这些变量单独或联合预测RS的能力有限。同样，常用指南和辅助在线软件均无法预测RS。
本研究结果表明，与临床试验人群相比，标准临床病理特征和常用评估工具均无法可靠地预测转诊乳腺癌患者的RS。这些数据还可能表明，需要针对RS在某些乳腺癌患者亚组中的作用进行更多研究，包括具有非浸润性导管癌组织学和存在淋巴结微转移的患者。
