Department of Gynecology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Breast Cancer Res Treat. 2013 Jan;137(1):57-67. doi: 10.1007/s10549-012-2296-x. Epub 2012 Nov 8.
High proliferation rates are characteristic of cancer, and proliferation markers make up the majority of genes included in RNA-based prognostic gene signatures applied for breast cancer patients. Based on prior data on differences in molecular subgroups of breast cancer, we hypothesized that the significance of single proliferation markers might differ in luminal, Her2-positive and triple-negative subtypes. Therefore, we compared mRNA expression data of Ki67, TOP2A, and RacGAP1 using a pool of 562 Affymetrix U133A microarrays from breast cancer samples. "Luminal," "triple-negative," and "Her2-positive" subcohorts were defined by ESR1 and ERBB2 mRNA expression using pre-defined cut-offs. The analysis of the three potential proliferation markers revealed subtype-specific differences: in luminal carcinomas, expression of all three markers was a significant indictor of early recurrence in univariate and multivariate analysis, but RacGAP1 was superior to Ki67 and TOP2A in significance. In triple-negative tumors, only Ki67 was a significant and independent marker, whereas none of the markers showed a significant prognostic impact in Her2-positive cases. Within the group of luminal carcinomas, the proliferation markers had different impact depending on the treatment of patients: in untreated patients, Ki67, TOP2A, and RacGAP1 were significant and independent prognostic markers. In chemotherapy-treated patients, overexpression of all three markers was predictive for early recurrence, but only RacGAP1 retained significance in multivariate analysis. In contrast, RacGAP1 was the only predictive proliferation marker in the endocrine treatment group. These data point to subtype-specific differences in the relevance of proliferation-associated genes, and RacGAP1 might be a strong prognostic and predictive marker in the luminal subgroup.
高增殖率是癌症的特征,增殖标志物构成了应用于乳腺癌患者的基于 RNA 的预后基因特征中大多数基因。基于先前关于乳腺癌分子亚组差异的数据,我们假设单个增殖标志物的意义在管腔型、Her2 阳性和三阴性亚型中可能不同。因此,我们比较了 Ki67、TOP2A 和 RacGAP1 的 mRNA 表达数据,使用了来自 562 个乳腺癌样本的 Affymetrix U133A 微阵列的一个池。“管腔型”、“三阴性”和“Her2 阳性”亚组通过 ESR1 和 ERBB2 mRNA 表达使用预定义的截止值来定义。对这三个潜在增殖标志物的分析揭示了亚组特异性差异:在管腔型癌中,所有三种标志物的表达在单变量和多变量分析中都是早期复发的显著指标,但 RacGAP1 在意义上优于 Ki67 和 TOP2A。在三阴性肿瘤中,只有 Ki67 是一个显著和独立的标志物,而在 Her2 阳性病例中,没有一个标志物显示出显著的预后影响。在管腔型癌组中,增殖标志物的影响因患者的治疗而异:在未治疗的患者中,Ki67、TOP2A 和 RacGAP1 是显著和独立的预后标志物。在化疗治疗的患者中,所有三种标志物的过度表达都是早期复发的预测指标,但只有 RacGAP1 在多变量分析中保留了意义。相比之下,RacGAP1 是内分泌治疗组中唯一的预测增殖标志物。这些数据表明与增殖相关的基因的相关性存在亚组特异性差异,RacGAP1 可能是管腔亚组中一个强有力的预后和预测标志物。
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