Alkushi Abdulmohsen, Omair Ahmad, Arabi Haitham, Masuadi Emad, Abualkhair Omalkhair
Department of Pathology, King Abdulaziz Medical City of National Guard, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences & King Abdullah International Medical Research Center Riyadh, Saudi Arabia.
Breast Cancer (Auckl). 2020 Dec 8;14:1178223420977848. doi: 10.1177/1178223420977848. eCollection 2020.
Oncotype Dx is used to predict the long-term recurrence risk in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative invasive breast cancer (BC). This study aimed at establishing a correlation between clinicopathological parameters and recurrence score (RS), subsequently improving predictability and ultimately justifying the use of the multigene assay.
A retrospective analysis of the pathology and clinical data of 114 female patients with BC who had Oncotype Dx testing between 2012 and 2019. The pathological parameters included are tumor cell type, tumor grade, pathological stage, and mitotic index (MI). The expression of ER, progesterone receptor (PR), HER2, and Ki67 was assessed by immunohistochemistry. A univariate and multivariate linear regression analysis was performed to assess the correlation between these parameters and the RS.
In univariate analysis, age (˂40 years), higher tumor grade, and low PR expression were significantly associated with higher RS ( = .02; ˂.001; and ˂.001, respectively). Both MI and Ki67 were also strongly correlated with an increase in the RS with a value of .01 (Spearman correlation 0.34 and 0.33). In multivariate linear regression analysis, age, MI, and Ki67 lost their significance, but both higher grade and PR remained significantly associated with a higher RS along with the tumor stage ( ˂ .001; ˂.001; and .04, respectively).
Tumor grade and PR immunohistochemical expression are the main predictors of RS in our study population. Other clinicopathological features were not significant predictors of change in RS in multivariate analysis.
Oncotype Dx用于预测雌激素受体（ER）阳性且人表皮生长因子受体2（HER2）阴性的浸润性乳腺癌（BC）患者的长期复发风险。本研究旨在建立临床病理参数与复发评分（RS）之间的相关性，进而提高预测能力，并最终证明多基因检测的应用合理性。
对2012年至2019年间接受Oncotype Dx检测的114例女性BC患者的病理和临床资料进行回顾性分析。纳入的病理参数包括肿瘤细胞类型、肿瘤分级、病理分期和有丝分裂指数（MI）。通过免疫组织化学评估ER、孕激素受体（PR）、HER2和Ki67的表达。进行单因素和多因素线性回归分析，以评估这些参数与RS之间的相关性。
在单因素分析中，年龄（<40岁）、较高的肿瘤分级和低PR表达与较高的RS显著相关（P值分别为0.02、<0.001和<0.001）。MI和Ki67也与RS的增加密切相关，P值为0.这表明两者与RS呈正相关，斯皮尔曼相关系数分别为0.34和0.33。在多因素线性回归分析中，年龄、MI和Ki67失去了其显著性，但较高的分级和PR以及肿瘤分期仍与较高的RS显著相关（P值分别为<0.001、<0.001和0.04）。
在我们的研究人群中，肿瘤分级和PR免疫组化表达是RS的主要预测因素。在多因素分析中，其他临床病理特征不是RS变化的显著预测因素。
