用于预测接受前哨淋巴结活检的原发性皮肤黑色素瘤患者结局的 31 基因表达谱的效用。
Utility of a 31-gene expression profile for predicting outcomes in patients with primary cutaneous melanoma referred for sentinel node biopsy.
机构信息
Department of Surgery, Division of Surgical Oncology, Oregon Health & Science University, Portland, OR, USA.
School of Public Health, Texas A and M University, College Station, TX, USA.
出版信息
Am J Surg. 2021 Jun;221(6):1195-1199. doi: 10.1016/j.amjsurg.2021.03.028. Epub 2021 Mar 17.
BACKGROUND
A 31-gene genetic expression profile (31-GEP; Class 1 = low risk, Class 2 = high risk) developed to predict outcome in cutaneous melanoma (CM) has been validated by retrospective, industry-sponsored, or small series.
METHODS
Tumor features, sentinel node biopsy (SNB) results, and outcomes were extracted from a prospective database of 383 C M patients who underwent SNB and had a 31-GEP run on their primary tumor. Groups were compared by uni- and multi-variable analysis. Relapse-free and distant metastasis-free survival (RFS, DMFS) were estimated by Kaplan-Meier method.
RESULTS
Breslow thickness, T stage, and SNB positivity were significantly higher in Class 2 patients. Recurrence rates were higher for Class 2 vs Class 1 patients and highest in patients who were Class 2 and SNB positive. GEP class was predictive of RFS and DMFS and independently predicted relapse in AJCC "low risk" (stages IA-IIA) patients.
CONCLUSIONS
31-GEP adds prognostic information in CM patents undergoing SNB.
背景
一种用于预测皮肤黑色素瘤（CM）患者预后的 31 基因表达谱（31-GEP；Class 1=低风险，Class 2=高风险）已通过回顾性、行业赞助或小系列研究得到验证。
方法
从 383 例接受前哨淋巴结活检（SNB）且原发肿瘤进行了 31-GEP 检测的 CM 患者的前瞻性数据库中提取肿瘤特征、SNB 结果和结局数据。通过单变量和多变量分析比较组间差异。采用 Kaplan-Meier 法估计无复发生存（RFS）和无远处转移生存（DMFS）。
结果
Class 2 患者的 Breslow 厚度、T 分期和 SNB 阳性率显著更高。Class 2 患者的复发率高于 Class 1 患者，Class 2 且 SNB 阳性患者的复发率最高。GEP 分级可预测 RFS 和 DMFS，并可独立预测 AJCC“低危”（IA-IIA 期）患者的复发。
结论
31-GEP 在接受 SNB 的 CM 患者中提供了预后信息。
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