Multidisciplinary Breast Centre, University Hospital Leuven, Leuven.
Department of Electrical Engineering (ESAT-SISTA), Katholieke Universiteit Leuven, Leuven, Belgium.
Ann Oncol. 2012 Oct;23(10):2578-2584. doi: 10.1093/annonc/mds062. Epub 2012 Apr 6.
Many easily measurable and readily available factors are now established as being prognostic in primary operable breast cancer. We here applied the 2011 St Gallen surrogate definition for breast cancer subclassification using tumor grade instead of Ki67.
Four thousand three hundred and eighteen consecutive patients who had surgery for primary operable breast cancer (1 January 2000 and 31 December 2009) in UZ Leuven excluding primary metastastic male breast cancers and those receiving neoadjuvant therapy. Five different surrogate phenotypes were created using the combined expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 together with tumor grade. Disease-free interval (DFI), distant metastastis-free interval (DMFI), locoregional relapse-free interval (LRRFI), breast cancer-specific survival (BCSS) and overall survival (OS) were calculated.
Surrogate phenotypes present with significant differences in DFI, DMFI, LRRFI, BCSS and OS. 'Luminal A' tumors presented with the best outcome parameters but the effect weakened at longer follow-up.
The four surrogate markers, agreed upon by the 2011 St Gallen consensus, defined five prognostic surrogate phenotypes in a large series of consecutively treated breast cancer patients. Their prognostic value changed with longer follow-up. The added value of gene expression profile over classical pathological assessment remains to be defined.
许多易于测量和易得的因素现已被确定为原发性可手术乳腺癌的预后因素。我们在此应用 2011 年圣加仑替代定义，使用肿瘤分级而不是 Ki67 对乳腺癌进行亚分类。
连续 4318 例在 UZ Leuven 接受原发性可手术乳腺癌手术（2000 年 1 月 1 日至 2009 年 12 月 31 日）的患者，不包括原发性转移性男性乳腺癌和接受新辅助治疗的患者。使用雌激素受体、孕激素受体、人表皮生长因子受体-2 的联合表达以及肿瘤分级，创建了 5 种不同的替代表型。计算无病间隔（DFI）、远处转移无病间隔（DMFI）、局部区域复发无病间隔（LRRFI）、乳腺癌特异性生存（BCSS）和总生存（OS）。
替代表型在 DFI、DMFI、LRRFI、BCSS 和 OS 方面存在显著差异。“管腔 A”肿瘤表现出最佳的预后参数，但随着随访时间的延长，效果减弱。
在 2011 年圣加仑共识中达成一致的四个替代标志物在一系列连续治疗的乳腺癌患者中定义了五个预后替代表型。随着随访时间的延长，其预后价值发生了变化。基因表达谱相对于经典病理评估的附加价值仍有待确定。
