Department of Surgery, National Defense Medical College, Tokorozawa, Japan,
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Oncology. 2020;98(8):534-541. doi: 10.1159/000506369. Epub 2020 Apr 1.
DNA microarrays, such as the consensus molecular subtype (CMS) classification using >600 genes, are used to predict cancer patient prognosis. We recently constructed a simple 55-gene classifier (55GC) system to risk stratify colon cancer (CC).
Here, we validate the 55GC specifically for stage II CC and compare it with CMS categories.
Tissue sections from 232 stage II CC patients who underwent curative surgery without adjuvant chemotherapy between 2009 and 2012 were subjected to DNA microarray analysis.
Based on the 55GC, patients were classified into microsatellite instability-like (27%), chromosomal instability-like (41%), and stromal (32%) subtypes with 5-year relapse-free survival (RFS) rates of 88.5, 83.3, and 71.2%, respectively (stromal vs. others: p = 0.0049). Multivariate analysis by Cox's proportional hazard model revealed that the stromal subtype, pT4, and the number of lymph nodes examined (<12) were independent poor prognostic factors. The overall concordance rate between 55GC and CMS was 72%, and 5-year RFS rates of patients with CMS1, CMS2, CMS3, and CMS4 cancers were 100, 85.5, 92.3, and 73.0%, respectively (p = 0.0113).
We conclude that the 55GC is a useful and reproducible grading system for stage II CC recurrence risk stratification.
DNA 微阵列，如使用>600 个基因的共识分子亚型（CMS）分类，用于预测癌症患者的预后。我们最近构建了一个简单的 55 个基因分类器（55GC）系统来对结肠癌（CC）进行风险分层。
本研究旨在专门针对 II 期 CC 验证 55GC，并将其与 CMS 类别进行比较。
对 2009 年至 2012 年间接受根治性手术且未接受辅助化疗的 232 例 II 期 CC 患者的组织切片进行 DNA 微阵列分析。
根据 55GC，患者被分为微卫星不稳定样（27%）、染色体不稳定样（41%）和基质样（32%）亚型，5 年无复发生存率（RFS）分别为 88.5%、83.3%和 71.2%（基质样与其他类型：p=0.0049）。Cox 比例风险模型的多变量分析显示，基质样、pT4 和检查的淋巴结数目（<12）是独立的预后不良因素。55GC 与 CMS 之间的总一致性率为 72%，CMS1、CMS2、CMS3 和 CMS4 癌症患者的 5 年 RFS 率分别为 100%、85.5%、92.3%和 73.0%（p=0.0113）。
我们得出结论，55GC 是一种用于 II 期 CC 复发风险分层的有用且可重复的分级系统。
