Chae Eun Young, Moon Woo Kyung, Kim Hak Hee, Kim Won Hwa, Cha Joo Hee, Shin Hee Jung, Choi Woo Jung, Han Wonshik, Noh Dong-Young, Lee Sae Byul, Ahn Sei Hyun
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2016 Jun 30;11(6):e0158461. doi: 10.1371/journal.pone.0158461. eCollection 2016.
A multigene expression assay corresponds to the likelihood of breast cancer recurrence after the initial diagnosis and can be used to guide the decision for additional chemotherapy. However, only few studies have investigated the associations between the imaging features of breast cancer and the results of multigene expression assays. Our study was to identify the relationship between imaging features on ultrasound (US) and the recurrence score (RS) on a 21-gene expression assay in patients with oestrogen receptor (ER)-positive, HER2-negative breast cancer. 267 patients with ER-positive, HER-negative invasive breast cancer who underwent examinations using US and Oncotype DX assay were included. US images were independently reviewed by dedicated breast radiologists who were blind to the RS. Tumour roundness was measured using a laboratory-developed software program. The pathological data were reviewed, including immunohistochemistry results. Univariate analysis was performed to assess the associations between the RS and each variable. Multiple logistic regression analysis was used to identify independent predictors of high RS. Of 267 patients, 147 (55%) had low, 96 (36%) intermediate, and 24 (9%) had high RS. According to the univariate analysis, parallel orientation, presence of calcification in the mass, and tumour roundness were positively associated with high RS. Multiple logistic regression analysis showed that parallel orientation (OR = 5.53) and tumour roundness (OR = 1.70 per 10 increase) were associated with high RS. Parallel orientation and tumour roundness are independent variables that may predict high RS in patients with ER-positive, HER2-negative breast cancer.
多基因表达检测与乳腺癌初次诊断后的复发可能性相关，可用于指导是否进行额外化疗的决策。然而，仅有少数研究调查了乳腺癌的影像特征与多基因表达检测结果之间的关联。我们的研究旨在确定雌激素受体（ER）阳性、人表皮生长因子受体2（HER2）阴性乳腺癌患者的超声（US）影像特征与21基因表达检测的复发评分（RS）之间的关系。纳入了267例接受了US检查和Oncotype DX检测的ER阳性、HER阴性浸润性乳腺癌患者。US图像由专门的乳腺放射科医生独立评估，这些医生对RS结果不知情。使用实验室开发的软件程序测量肿瘤的圆形度。审查病理数据，包括免疫组化结果。进行单因素分析以评估RS与每个变量之间的关联。采用多因素logistic回归分析确定高RS的独立预测因素。267例患者中，147例（55%）RS较低，96例（36%）中等，24例（9%）RS较高。根据单因素分析，平行方位、肿块内钙化的存在以及肿瘤圆形度与高RS呈正相关。多因素logistic回归分析显示，平行方位（比值比[OR]=5.53）和肿瘤圆形度（每增加10单位OR=1.70）与高RS相关。平行方位和肿瘤圆形度是可能预测ER阳性、HER2阴性乳腺癌患者高RS的独立变量。
