Department of Medicine, Indiana University, School of Medicine, Indianapolis, IN 46202, USA.
Mod Pathol. 2010 Feb;23(2):270-5. doi: 10.1038/modpathol.2009.172. Epub 2009 Nov 27.
The Oncotype DX assay is one of the molecular tests that provide predictive and prognostic information to breast cancer patients with estrogen receptor (ER)-positive and node-negative disease. This study evaluates the association of Forkhead-box protein A1 (FOXA1) and GATA-binding protein 3 (GATA3) expressions with Oncotype DX recurrences scores in 77 cases of patients with ER-positive node-negative breast carcinomas diagnosed at Indiana University. The data were correlated with patient age, tumor size, histologic type, Scarff-Bloom-Richardson score, histologic grade, and progesterone receptor status. The median FOXA1 and GATA3 scores were 240 and 200, respectively. The Oncotype DX recurrence scores were low in 57%, intermediate in 30%, and high in 13% of cases. FOXA1 expression correlated negatively with Oncotype DX recurrence scores (P=0.004), and histologic type (P=0.0004). Oncotype DX recurrences score also correlated negatively with progesterone receptor (P=0.035) with 100% of progesterone receptor-negative cases having high or intermediate Oncotype DX scores. FOXA1 and GATA3 expressions correlated positively (P=0.014). The correlation between FOXA1 expression and Oncotype DX recurrence scores remained significant after adjusting for multiple comparisons and controlling for confounders such as histological type, grade, and progesterone receptor. A statistically significant correlation between the Oncotype DX recurrence scores and FOXA1 expression in our diverse cohort of ER-positive breast cancer patients was observed. We propose that this may represent a more cost-effective strategy to further risk stratify patients with good prognosis in whom chemotherapy may be omitted. To confirm these findings, further studies in a larger cohort of patients are warranted.
Oncotype DX 检测是一种分子检测方法，可为雌激素受体（ER）阳性和淋巴结阴性的乳腺癌患者提供预测和预后信息。本研究评估了在印第安纳大学诊断为 ER 阳性淋巴结阴性乳腺癌的 77 例患者中，叉头框蛋白 A1（FOXA1）和 GATA 结合蛋白 3（GATA3）的表达与 Oncotype DX 复发评分之间的关系。这些数据与患者年龄、肿瘤大小、组织学类型、Scarff-Bloom-Richardson 评分、组织学分级和孕激素受体状态相关。FOXA1 和 GATA3 评分的中位数分别为 240 和 200。Oncotype DX 复发评分低的占 57%，中危的占 30%，高危的占 13%。FOXA1 表达与 Oncotype DX 复发评分呈负相关（P=0.004），与组织学类型呈负相关（P=0.0004）。Oncotype DX 复发评分与孕激素受体也呈负相关（P=0.035），100%孕激素受体阴性的病例均为高或中危 Oncotype DX 评分。FOXA1 和 GATA3 的表达呈正相关（P=0.014）。FOXA1 表达与 Oncotype DX 复发评分之间的相关性在经过多因素比较调整和控制组织学类型、分级和孕激素受体等混杂因素后仍然显著。在我们的 ER 阳性乳腺癌患者的多样化队列中，观察到 Oncotype DX 复发评分与 FOXA1 表达之间存在显著的相关性。我们提出，这可能代表一种更具成本效益的策略，可以进一步对预后良好的患者进行风险分层，从而避免化疗。为了证实这些发现，需要在更大的患者队列中进行进一步的研究。
