We report a 23- gene-classifier profiled from Asian women, with the primary purpose of assessing its clinical utility towards improved risk stratification for relapse for breast cancer patients from Asian cohorts within 10-years' following mastectomy. Four hundred and twenty-two breast cancer patients underwent mastectomy and were used to train the classifier on a logistic regression model. A subset of 197 patients were chosen to be entered into the follow-up studies post mastectomy who were examined to determine the patterns of recurrence and survival analysis based on gene expression of the gene classifier, age at diagnosis, tumor stage and lymph node status, over a 5 and 10 years follow up period. Metastasis to lymph node (N2-N3) with N0 as the reference (N2 vs N0 hazard ratio: 2.02 (1.05-8.70), N3 vs N0 hazard ratio: 4.32 (1.41-13.22) for 5-years) and gene expression of the 23-gene panel (P=0.06 (5-years) and 0.02 (10-years), log-rank test), were found to have significant discriminatory effects on the risk of relapse (HR (95%CI):2.50(0.95-6.50)). Furthermore, survival curves for subgroup analysis with N0-N1 and T1-T2 predicted patients with higher risk scores. The study provides robust evidence of the effectiveness of the 23-gene-classifier and could be used to determine the risk of relapse event (locoregional and distant recurrence) in Asian patients, leading to a meaningful reduction in chemotherapy recommendations.

中文翻译：

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一种23基因的预后分类器，用于预测亚洲乳腺癌患者的复发和生存率。

我们报告了亚洲女性的23种基因分类器，其主要目的是评估其在乳腺癌切除术后10年内改善亚洲人群乳腺癌患者复发风险分层的临床效用。422名乳腺癌患者接受了乳房切除术，并被用于在逻辑回归模型上训练分类器。选择了197例患者的一部分进行乳房切除术后的随访研究，根据基因分类器的基因表达，诊断年龄，肿瘤分期和淋巴结状态，对这些患者进行检查以确定复发和生存分析的模式，在5年和10年的随访期内。以N0为参考转移至淋巴结（N2-N3）（N2 vs N0危险比：2.02（1.05-8.70），N3 vs N0危险比：4.32（1.41-13。22）（5年）和23个基因组的基因表达（P = 0.06（5年）和0.02（10年），对数秩检验），对罹患肝癌的风险具有明显的歧视性影响。复发（HR（95％CI）：2.50（0.95-6.50））。此外，使用N0-N1和T1-T2进行亚组分析的生存曲线可预测风险评分较高的患者。这项研究为23基因分类器的有效性提供了有力的证据，可用于确定亚洲患者复发事件（局部和远处复发）的风险，从而导致化疗建议的显着减少。使用N0-N1和T1-T2进行亚组分析的生存曲线可预测风险评分较高的患者。这项研究为23基因分类器的有效性提供了有力的证据，可用于确定亚洲患者复发事件（局部和远处复发）的风险，从而导致化疗建议的显着减少。使用N0-N1和T1-T2进行亚组分析的生存曲线可预测风险评分较高的患者。这项研究为23基因分类器的有效性提供了有力的证据，可用于确定亚洲患者复发事件（局部和远处复发）的风险，从而导致化疗建议的显着减少。