NEJM:乳腺癌21基因表达检测的前瞻性验证

2015-11-23 MedSci MedSci原创

既往使用前瞻性回顾设计包括档案肿瘤样本的研究显示,基因表达分析可为患者的预后提供有用的临床信息。然而,一项高质量的前瞻性实验研究证实了生物标志物的临床有效性和实用性。

既往使用前瞻性回顾设计(包括档案肿瘤样本)的研究显示,基因表达分析可为患者的预后提供有用的临床信息。然而,一项高质量的前瞻性实验研究证实了生物标志物的临床有效性和实用性。

该前瞻性试验中,研究共纳入了激素受体阳性、人表皮生长因子受体2型(HER-2)阴性、腋淋巴结转移阴性的乳癌患者,其中患者的肿瘤直径在1.1-5.0 cm之间(或中位和最大直径在0.6-1.0 cm之间或高分级肿瘤),这也是基于临床病理学特征判断哪位患者达到了需要接受辅助化疗的标准。使用PCR技术分析了石蜡包埋的肿瘤组织所表达的21基因,结果用于计算预测患者乳腺癌复发风险的得分。安排患者接受内分泌治疗而无需化疗,若此时得分为0-10,那么这意味着患者乳腺癌的复发风险较低。

结果共有10253名合格的女性纳入研究,1626名女性乳腺癌复发得分在0-10之间,接受内分泌治疗而无需化疗。随访5年,侵袭性乳腺癌患者的无病存活率为93.8%,癌症未发生远处转移的概率为99.3%,癌症未原位复发也未远处转移的概率为98.7%,总体生存率为98.0%。

总而言之,那些激素受体阳性、HER-2 阴性、腋淋巴结转移阴性的乳癌患者基于其临床病理学特征符合既定的指导方针,而那些具有良好的基因表达谱的肿瘤患者仅接受内分泌治疗其肿瘤的5年复发率很低。

原始出处;

Joseph A. Sparano, Robert J. Gray. Prospective Validation of a 21-Gene Expression Assay in Breast Cancer. N Engl J Med 2015; 373:2005-2014. November 19, 2015.

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    2016-09-13 doctorJiangchao

    继续学习

    0

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    2016-09-13 doctorJiangchao

    继续关注

    0

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    2015-11-25 Jianghuiqin

    很有意义!

    0

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