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The expression of four genes as a prognostic classifier for stage I lung adenocarcinoma in 12 independent cohorts.


ABSTRACT: BACKGROUND:We previously developed a prognostic classifier using the expression levels of BRCA1, HIF1A, DLC1, and XPO1 that identified stage I lung adenocarcinoma patients with a high risk of relapse. That study evaluated patients in five independent cohorts from various regions of the world. In an attempt to further validate the classifier, we have used a meta-analysis-based approach to study 12 cohorts consisting of 1,069 tumor-node-metastasis stage I lung adenocarcinoma patients from every suitable, publically available dataset. METHODS:Cohorts were obtained through a systematic search of public gene expression datasets. These data were used to calculate the risk score using the previously published 4-gene risk model. A fixed effect meta-analysis model was used to generate a pooled estimate for all cohorts. RESULTS:The classifier was associated with prognosis in 10 of the 12 cohorts (P < 0.05). This association was highly consistent regardless of the ethnic diversity or microarray platform. The pooled estimate demonstrated that patients classified as high risk had worse overall survival for all stage I [HR, 2.66; 95% confidence interval (CI), 1.93-3.67; P < 0.0001] patients and in stratified analyses of stage IA (HR, 2.69; 95% CI, 1.66-4.35; P < 0.0001) and stage IB (HR, 2.69; 95% CI, 1.74-4.16; P < 0.0001) patients. CONCLUSIONS:The 4-gene classifier provides independent prognostic stratification of stage IA and stage IB patients beyond conventional clinical factors. IMPACT:Our results suggest that the 4-gene classifier may assist clinicians in decisions about the postoperative management of early-stage lung adenocarcinoma patients.

SUBMITTER: Okayama H 

PROVIDER: S-EPMC4257875 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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The expression of four genes as a prognostic classifier for stage I lung adenocarcinoma in 12 independent cohorts.

Okayama Hirokazu H   Schetter Aaron J AJ   Ishigame Teruhide T   Robles Ana I AI   Kohno Takashi T   Yokota Jun J   Takenoshita Seiichi S   Harris Curtis C CC  

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20140921 12


<h4>Background</h4>We previously developed a prognostic classifier using the expression levels of BRCA1, HIF1A, DLC1, and XPO1 that identified stage I lung adenocarcinoma patients with a high risk of relapse. That study evaluated patients in five independent cohorts from various regions of the world. In an attempt to further validate the classifier, we have used a meta-analysis-based approach to study 12 cohorts consisting of 1,069 tumor-node-metastasis stage I lung adenocarcinoma patients from  ...[more]

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