Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada.
J Clin Oncol. 2013 Jun 1;31(16):2047-54. doi: 10.1200/JCO.2012.46.6615. Epub 2013 Apr 29.
With the ultimate aim of improving clinical management of breast cancer, investigators have sought to identify molecular genetic markers that stratify newly diagnosed patients into subtypes differing in short- or long-term prognosis. Conventional survival models can fail to describe adequately the relationship between subtype and disease recurrence, particularly when there is a substantial proportion of long-term disease-free survivors. The observed patterns of disease-free survival in an undifferentiated patient cohort may be explained by an underlying mixture of two subgroups: patients who will remain free of disease in the long term (ie, cured), and those who will experience disease recurrence within their lifetime (ie, susceptible.) In this article, we review the concepts and methods of the mixture cure models and apply them in the analysis of molecular genetic prognostic factors for disease-free survival and time to disease recurrence in a cohort of patients with axillary lymph node-negative breast cancer.
研究人员旨在通过识别分子遗传标志物，将新诊断的乳腺癌患者分为短期或长期预后不同的亚型，以此改善乳腺癌的临床管理。传统的生存模型可能无法充分描述亚型与疾病复发之间的关系，尤其是当存在大量长期无病生存者时。在一个未分化的患者队列中观察到的无病生存模式可以用两个亚组的混合来解释：长期无病（即治愈）的患者和在其一生中会经历疾病复发的患者（即易患）。在本文中，我们回顾了混合治愈模型的概念和方法，并将其应用于腋窝淋巴结阴性乳腺癌患者队列中无病生存和疾病复发时间的分子遗传预后因素的分析。
