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朱志华

副主任医师 副教授

中山大学附属肿瘤医院 胸外科

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朱志华

朱志华

副主任医师 副教授
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学术前沿

朱志华副教授在国际著名医学杂志《柳叶刀》发表肺癌论文

发表者:朱志华 2167人已读

  https://www.sysucc.org.cn/news.asp?selectclassid=001004&id=2822

 (中心办报道) 近日,我中心胸外科朱志华教授参与的,包括美国旧金山加利福尼亚大学胸外科,美国Kaiser Permanente 研究中心、美国Pinpoint Genomics实验室、广州医学院附属第一医院、上海肺科医院、北京首都医科大学等多中心在内的一项肺癌预后预测研究,取得了新进展,研究论著《A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies》作为封面论文发表于世界著名医学期刊《The Lancet》。中山大学附属肿瘤医院胸外科朱志华

        此次的多中心合作研究利用定量PCR方法寻找并建立了一个包括14个基因的分子标记物群,分别成功的对包括361位,433位及1006位早期肺癌术后病人的预后进行了预测和验证。通过这种方法可以将术后的此类病人,区分成高危、中危和低危的三组,三组的5年生存率分别49.2%、58.3%和71.4%。肺癌的个体化预后预测,即如何准确找到预后差的病人予以干预治疗,同时避免对预后好病人的过度治疗,本研究进一步为早期肺癌患者术后的个体化治疗的选择提供科学依据。

        朱志华教授在多家单位中排名第三(前两名为共同第一作者),这是我院首次在《The Lancet》主杂志发表文章,也是继朱志华教授肺癌研究在国际肿瘤学顶级杂志《Journal of Clinical Oncology》发表高影响因子论文后的一次新突破。此次合作扩大了我院在该领域的国际影响,为进一步的国际合作奠定了良好基础。

The Lancet, Early Online Publication, 27 January 2012
doi:10.1016/S0140-6736(11)61941-7Cite or Link Using DOI
A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies
Johannes R Kratz MD a ‡, Prof Jianxing He MD b ‡, Stephen K Van Den Eeden PhD c, Prof Zhi-Hua Zhu MD d, Prof Wen Gao MD e, Patrick T Pham BS a, Michael S Mulvihill BS a, Fatemeh Ziaei BS f, Huanrong Zhang MD b, Bo Su MD e, Prof Xiuyi Zhi MD g, Charles P Quesenberry PhD c, Laurel A Habel BS c, Qiuhua Deng BS b, Zongfei Wang BS b, Jiangfen Zhou BS b, Huiling Li PhD b, Mei-Chun Huang PhD f, Che-Chung Yeh PhD a, Prof Mark R Segal PhD a, M Roshni Ray BS a, Prof Kirk D Jones MD a, Dan J Raz MD a, Zhidong Xu MD a, Thierry M Jahan MD a, David Berryman PharmD f, Biao He PhD a, Dr Michael J Mann MD a , Prof David M Jablons MD a
Summary
 
Background
The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging.
Methods
A 14-gene expression assay that uses quantitative PCR, runs on formalin-fixed paraffin-embedded tissue samples, and differentiates patients with heterogeneous statistical prognoses was developed in a cohort of 361 patients with non-squamous NSCLC resected at the University of California, San Francisco. The assay was then independently validated by the Kaiser Permanente Division of Research in a masked cohort of 433 patients with stage I non-squamous NSCLC resected at Kaiser Permanente Northern California hospitals, and on a cohort of 1006 patients with stage I—III non-squamous NSCLC resected in several leading Chinese cancer centres that are part of the China Clinical Trials Consortium (CCTC).
Findings
Kaplan-Meier analysis of the Kaiser validation cohort showed 5 year overall survival of 71·4% (95% CI 60·5—80·0) in low-risk, 58·3% (48·9—66·6) in intermediate-risk, and 49·2% (42·2—55·8) in high-risk patients (ptrend=0·0003). Similar analysis of the CCTC cohort indicated 5 year overall survivals of 74·1% (66·0—80·6) in low-risk, 57·4% (48·3—65·5) in intermediate-risk, and 44·6% (40·2—48·9) in high-risk patients (ptrend<0·0001). Multivariate analysis in both cohorts indicated that no standard clinical risk factors could account for, or provide, the prognostic information derived from tumour gene expression. The assay improved prognostic accuracy beyond National Comprehensive Cancer Network criteria for stage I high-risk tumours (p<0·0001), and differentiated low-risk, intermediate-risk, and high-risk patients within all disease stages.
Interpretation
Our practical, quantitative-PCR-based assay reliably identified patients with early-stage non-squamous NSCLC at high risk for mortality after surgical resection.
Funding
UCSF Thoracic Oncology Laboratory and Pinpoint Genomics.

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发表于:2012-01-29 22:50

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