Background: Genome-wide measures of gene expression can identify patterns of gene activity that subclassify tumours and might provide a better means than is currently available for individual risk assessment in patients with lymph-node-negative breast cancer. VSports手机版.

Methods: We analysed, with Affymetrix Human U133a GeneChips, the expression of 22000 transcripts from total RNA of frozen tumour samples from 286 lymph-node-negative patients who had not received adjuvant systemic treatment V体育安卓版. .

Findings: In a training set of 115 tumours, we identified a 76-gene signature consisting of 60 genes for patients positive for oestrogen receptors (ER) and 16 genes for ER-negative patients. This signature showed 93% sensitivity and 48% specificity in a subsequent independent testing set of 171 lymph-node-negative patients. The gene profile was highly informative in identifying patients who developed distant metastases within 5 years (hazard ratio 5. 67 [95% CI 2. 59-12. 4]), even when corrected for traditional prognostic factors in multivariate analysis (5. 55 [2. 46-12. 5]). The 76-gene profile also represented a strong prognostic factor for the development of metastasis in the subgroups of 84 premenopausal patients (9. 60 [2. 28-40 V体育ios版. 5]), 87 postmenopausal patients (4. 04 [1. 57-10. 4]), and 79 patients with tumours of 10-20 mm (14. 1 [3. 34-59. 2]), a group of patients for whom prediction of prognosis is especially difficult. .

Interpretation: The identified signature provides a powerful tool for identification of patients at high risk of distant recurrence. The ability to identify patients who have a favourable prognosis could, after independent confirmation, allow clinicians to avoid adjuvant systemic therapy or to choose less aggressive therapeutic options. VSports最新版本.