Li Guan-Qiao, Yao Jia, Zhou Ping, Chen Dan-Xia, Lian Chen-Lu, Yang Shi-Ping, Huang Cai-Hong, Wu San-Gang
Department of Breast Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, People's Republic of China.
Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
Clin Breast Cancer. 2022 Apr;22(3):279-287. doi: 10.1016/j.clbc.2021.11.003. Epub 2021 Nov 14.
To compare the distribution, chemotherapy-decision making, and prognosis of the 21-gene recurrence score (RS) between Chinese breast cancer (BC) in the United States and White American (WA) BC.
We identified early-stage and estrogen receptor-positive BC patients diagnosed between 2004 and 2015. Multivariate logistic regression, Kaplan-Meier analysis, and multivariate Cox proportional hazards models were used for statistical analyses.
A total of 67,486 patients were identified, including 66,215 (98.1%) WA patients and 1271 (1.9%) Chinese patients. Regarding the RS, 38,894 (57.6%) had low RS, 23,882 (35.4%) had intermediate RS, and 4710 (7.0%) had high RS. A similar distribution of RS was found between WA and Chinese BC (P = .280). The race was not the predictor associated with high RS. Similar trends of chemotherapy use were found in Chinese and WA BC. In WA BC, there were 4.1%, 31.5%, and 72.2% of patients receiving chemotherapy in low, intermediate, and high RS cohorts, respectively (P < .001). The proportion of chemotherapy use was 6.8%, 30.9%, and 74.0% in Chinese BC with low, intermediate, and high RS cohorts, respectively (P < 0.001). The multivariate prognostic analyses indicated that a higher RS was independently associated with an inferior breast cancer-specific survival. Similar trends were found among those with Chinese and WA BC.
Our results demonstrate similar distribution, chemotherapy use, and outcome of the 21-gene RS between Chinese and WA BC in the United States.
比较美国华裔乳腺癌（BC）与美国白人乳腺癌（WA BC）的21基因复发评分（RS）的分布、化疗决策及预后情况。
我们纳入了2004年至2015年间诊断的早期雌激素受体阳性乳腺癌患者。采用多变量逻辑回归、Kaplan-Meier分析和多变量Cox比例风险模型进行统计分析。
共纳入67486例患者，其中66215例（98.1%）为WA患者，1271例（1.9%）为华裔患者。关于RS，38894例（57.6%）RS较低，23882例（35.4%）RS中等，4710例（7.0%）RS较高。WA BC和华裔BC的RS分布相似（P = 0.280）。种族不是与高RS相关的预测因素。华裔和WA BC的化疗使用趋势相似。在WA BC中，低、中、高RS队列中接受化疗的患者分别为4.1%、31.5%和72.2%（P < 0.001）。华裔BC低、中、高RS队列中化疗使用比例分别为6.8%、30.9%和74.0%（P < 0.001）。多变量预后分析表明，较高的RS与较差的乳腺癌特异性生存率独立相关。华裔和WA BC患者中也发现了类似趋势。
我们的结果表明，在美国，华裔和WA BC的21基因RS在分布、化疗使用和结果方面相似。
