Department of Breast and Thyroid Surgery, Jinhua Municipal Central Hospital, 365 East Renmin Road, Jinhua City, 321000, Zhejiang Province, China.
Department of Breast and Thyroid Surgery, Jinhua Maternal and Child Health Care Hosptital, Jinhua City, 321000, Zhejiang Province, China.
Breast Cancer. 2023 May;30(3):478-488. doi: 10.1007/s12282-023-01440-x. Epub 2023 Mar 1.
Although breast cancer (BC) has a low mortality rate relative to other cancers, it prominently affects the survival of patients with human epidermal growth factor receptor-2 (HER2 +) BC due to its high recurrence rate. By far, it has been found that autophagy can affect various tumor occurrence and development, as well as patients' prognosis. HER2 + BC patient samples and autophagy-related genes (ARGs) were acquired from a public database, least absolute shrinkage and selection operator (LASSO) and Cox analyses (including univariate and multivariate analyses) were utilized to construct a 9-ARGs model, which was verified by using HER2 + BC patient samples in The Cancer Genome Atlas (TCGA) dataset. Sample risk score was worked out based on characteristic genes, and prominent differences in overall survival were tracked down between high- and low-risk groups. Predictive ability of the model was validated by drawing receiver operating characteristic (ROC) curves and then calculating the area under the curves (AUC) value. Results showed good accuracy and prediction ability of the model in both validation set and training set. For the purpose of facilitating model application in clinical practice, we constructed a nomogram combing clinical factors and risk scores to evaluate 1-year, 3-year and 5-year survival of HER2 + BC patients. In addition, we assessed the correlation of risk score with tumor mutational burden and tumor immune infiltration. Results exhibited that in a high-risk group, tumor mutation was relatively high, while tumor immune infiltration was relatively poor. Overall, based on ARGs, the prognostic signature in this study can tellingly evaluate prognoses of HER2 + BC patients and provide a reference for clinicians.
虽然乳腺癌（BC）的死亡率相对其他癌症较低，但由于其高复发率，它显著影响了人类表皮生长因子受体 2（HER2+）BC 患者的生存。到目前为止，已经发现自噬可以影响各种肿瘤的发生和发展，以及患者的预后。从公共数据库中获取了 HER2+BC 患者样本和自噬相关基因（ARGs），利用最小绝对收缩和选择算子（LASSO）和 Cox 分析（包括单因素和多因素分析）构建了 9-ARGs 模型，并通过使用 HER2+BC 在癌症基因组图谱（TCGA）数据集的患者样本进行了验证。根据特征基因计算样本风险评分，并追踪高低风险组之间的总体生存率差异。通过绘制接收器工作特征（ROC）曲线然后计算曲线下面积（AUC）值来验证模型的预测能力。结果表明，该模型在验证集和训练集中均具有良好的准确性和预测能力。为了促进模型在临床实践中的应用，我们构建了一个结合临床因素和风险评分的列线图，以评估 HER2+BC 患者的 1 年、3 年和 5 年生存率。此外，我们评估了风险评分与肿瘤突变负担和肿瘤免疫浸润的相关性。结果表明，在高风险组中，肿瘤突变相对较高，而肿瘤免疫浸润相对较差。总体而言，基于 ARGs，本研究中的预后特征可以准确评估 HER2+BC 患者的预后，并为临床医生提供参考。
