21基因表达测定与雌激素受体阳性乳腺癌围绝经期患者的临床结局。
21-gene expression assay and clinical outcomes of premenopausal patients with hormone receptor-positive breast cancer.
发表日期：2023 Sep 17
作者：
Jaewon Hyung, Sae Byul Lee, Jisun Kim, Hee Jeong Kim, BeomSeok Ko, Jong Won Lee, Byung-Ho Son, Hee Jin Lee, Gyungyub Gong, Hyehyun Jeong, Jae Ho Jeong, Jeong Eun Kim, Jin-Hee Ahn, Kyung Hae Jung, Sung-Bae Kim
来源：
INTERNATIONAL JOURNAL OF CANCER
摘要：
基于21基因表达测定的复发评分（RS）在绝经前妇女中的预后作用尚未明确，我们调查了韩国首尔安山医疗中心在2005年6月至2018年7月之间接受21基因表达测定的绝经前患者的预后结果与RS的关联。根据STEEP版本2.0比较了侵袭性乳腺癌无复发生存（IBCFS）与RS和临床危险因素之间的差异。我们的研究纳入了554名患者，其中116名患者（20.9%）年龄小于40岁，238名患者（43.0%）为分化型B（Ki67 ≥20%），83名患者（15.0%）的RS >25。所有患者接受辅助性他莫昔芬 ± 化疗。总地来说，RS >25的患者在多变量分析中显示了更差的IBCFS趋势（调整HR 1.89 [95% CI: 0.95-3.73]，P = .069）。当根据年龄和分化亚型进行预后比较时，与其他患者（分化型A或分化型B + 年龄≥40岁，n = 494）相比，分化型B亚型和年龄<40岁的患者（n = 60）显示出明显更差的结局（调整HR 2.95 [95% CI: 1.49-5.82]，log-rank P < .001）。在分化型B亚型和年龄<40岁的患者中，IBCFS与RS之间没有明显关联（log-rank P = .51）。总之，虽然RS >25与绝经前妇女的预后不佳有关，但在分化型B亚型和年龄<40岁的患者中，其预后意义可能较小。© 2023 UICC.
The prognostic role of the recurrence score (RS) based on the 21-gene expression assay in premenopausal women is not well delineated, and we investigated the association of outcomes and the RS in premenopausal patients who had 21-gene expression assay at Asan Medical Center, Seoul, Korea, between June 2005 and July 2018. Invasive breast cancer-free survival (IBCFS) by STEEP version 2.0 was compared according to the RS and clinical risk factors. A total of 554 patients were included in our study and 116 patients (20.9%) had age <40 years, 238 patients (43.0%) had luminal B subtype (Ki67 ≥ 20%), and 83 patients (15.0%) had RS >25. All patients received adjuvant tamoxifen ± chemotherapy. Overall, patients with RS >25 showed trend toward worse IBCFS from multivariable analysis (adjusted HR 1.89 [95% CI: 0.95-3.73], P = .069). When comparing outcomes according to age and luminal subtypes, patients with luminal B subtype and age <40 years (n = 60) showed significantly worse outcomes compared to the others (luminal A or luminal B + age ≥40 years, n = 494; adjusted HR 2.95 [95% CI: 1.49-5.82], log-rank P < .001). Among patients with luminal B subtype and age <40 years, there was no significant association observed between IBCFS and the RS (log-rank P = .51). In conclusion, while RS >25 showed association with poor outcomes in premenopausal women, it may have less prognostic significance among those with luminal B subtype and age <40 years.© 2023 UICC.