Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2021 Aug 11;12:725161. doi: 10.3389/fendo.2021.725161. eCollection 2021.
Comprehensive investigations of the associations between 21-gene recurrence assay and metabolic profiles in Chinese breast cancer patients are limited.
We evaluated the relations of the 21-gene recurrence risk score (RS) and the expression of cancer-related genes with metabolic factors and biomarkers of insulin and the insulin-like growth factor (IGF) axis, and examined the interactions between the 21-gene RS and these metabolic profiles on breast cancer recurrence in Chinese women with HR-positive, HER2-negative early-stage breast cancer.
The 21-gene RS was inversely associated with body mass index ([BMI]β: -0.178 kg/m; P=0.040), the homeostasis model assessment of insulin resistance index ([HOMA-IR] β: -0.031; P=0.042), insulin (β: -0.036 uIU/ml; P=0.009), and C-peptide (β: -0.021 ug/L; P=0.014) and was positively associated with high-density lipoprotein cholesterol (β: 0.025 mmol/L; P=0.004), which were driven by the relation patterns between specific cancer-related genes and these metabolic profiles. Each 10-unit increase in the 21-gene RS was associated with 28% (95% CI: 5-47%) higher risk of breast cancer recurrence; this association was also observed in patients with favorable metabolic profiles in relevant to an absence of obesity, insulin resistance, hyperglycemia, hypertension, or dyslipidemia (28-44% higher risk) and among women with a low level of insulin, C-peptide, or the IGF1/IGFBP3 ratio (41-155% higher risk).
The 21-gene RS was related to favorable metabolic profiles including lower BMI, HOMA-IR, insulin, and C-peptide, and higher HDL in Chinese breast cancer patients, and its prognostic impact on breast cancer recurrence was more likely to present among patients with relatively favorable metabolic profiles.
在中国乳腺癌患者中，对 21 基因复发评分与代谢特征之间的相关性进行全面研究的情况有限。
我们评估了 21 基因复发风险评分（RS）与癌症相关基因的表达与代谢因素和胰岛素及胰岛素样生长因子（IGF）轴生物标志物之间的关系，并检测了中国 HR 阳性、HER2 阴性早期乳腺癌女性中，21 基因 RS 与这些代谢特征之间的相互作用对乳腺癌复发的影响。
21 基因 RS 与体重指数（BMI）呈负相关（β：-0.178kg/m；P=0.040），与稳态模型评估的胰岛素抵抗指数（HOMA-IR）呈负相关（β：-0.031；P=0.042），与胰岛素（β：-0.036uIU/ml；P=0.009）和 C 肽（β：-0.021ug/L；P=0.014）呈负相关，与高密度脂蛋白胆固醇（β：0.025mmol/L；P=0.004）呈正相关，这是由特定癌症相关基因与这些代谢特征之间的关系模式驱动的。21 基因 RS 每增加 10 个单位，乳腺癌复发风险增加 28%（95%CI：5-47%）；在与肥胖、胰岛素抵抗、高血糖、高血压或血脂异常无关的患者（复发风险增加 28-44%）以及胰岛素、C 肽或 IGF1/IGFBP3 比值较低的患者（复发风险增加 41-155%）中也观察到了这种相关性。
21 基因 RS 与包括 BMI、HOMA-IR、胰岛素和 C 肽降低以及 HDL 升高在内的有利代谢特征相关，其对乳腺癌复发的预后影响在代谢特征相对有利的患者中更有可能出现。
