ABSTRACT
CanAssist Breast (CAB), a prognostic test uses immunohistochemistry (IHC) approach coupled with artificial intelligence-based machine learning algorithm for prognosis of early-stage hormone-receptor positive, HER2/neu negative breast cancer patients. It was developed and validated in an Indian cohort. Here we report the first blinded validation of CAB in a multi-country European patient cohort. FFPE tumor samples from 864 patients were obtained from-Spain, Italy, Austria, and Germany. IHC was performed on these samples, followed by recurrence risk score prediction. The outcomes were obtained from medical records. The performance of CAB was analyzed by hazard ratios (HR) and Kaplan Meier curves. CAB stratified European cohort (n = 864) into distinct low- and high-risk groups for recurrence (P < 0.0001) with HR of 3.32 (1.85-5.93) like that of mixed (India, USA, and Europe) (n = 1974), 3.43 (2.34-4.93) and Indian cohort (n = 925), 3.09 (1.83-5.21). CAB provided significant prognostic information (P < 0.0001) in women aged ≤ 50 (HR: 4.42 (1.58-12.3), P < 0.0001) and >50 years (HR: 2.93 (1.44-5.96), P = 0.0002). CAB had an HR of 2.57 (1.26-5.26), P = 0.01) in women with N1 disease. CAB stratified significantly higher proportions (77%) as low-risk over IHC4 (55%) (P < 0.0001). Additionally, 82% of IHC4 intermediate-risk patients were stratified as low-risk by CAB. Accurate risk stratification of European patients by CAB coupled with its similar performance inIndian patients shows that CAB is robust and functions independent of ethnic differences. CAB can potentially prevent overtreatment in a greater number of patients compared to IHC4 demonstrating its usefulness for adjuvant systemic therapy planning in European breast cancer patients.
Subject(s)
Breast Neoplasms , Artificial Intelligence , Biomarkers, Tumor , Breast/pathology , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Female , Humans , Neoplasm Recurrence, Local/pathology , Prognosis , Receptor, ErbB-2 , Retrospective StudiesABSTRACT
Introducción: La población de adultos mayores se viene incrementando en el país y su problemática es compleja. Es un grupo de riesgo, con problemas de salud y nutrición causados por una serie de factores, entre ellos los socioeconómicos. Objetivos: Determinar la asociación de los hábitos alimentarios y estado nutricional con el nivel socioeconómico (NSE) de los adultos mayores que asisten a un Programa Municipal. Diseño: Estudio descriptivo, transversal. Lugar: Programa Municipal del Adulto Mayor en cuatro distritos de Lima Metropolitana. Participantes: Personas mayores de 60 años de ambos sexos. Intervenciones: Se determinó el peso y la talla (por altura de rodilla) a 115 personas mayores de 60 años que asistían constantemente al Programa Municipal. Se les aplicó una encuesta sobre hábitos alimentarios y otra para establecer el nivel socioeconómico, ambas previamente validadas. Principales medidas de resultados: Estado nutricional según índice de masa corporal, hábitos alimentarios adecuados según recomendaciones y nivel socioeconómico según categorías de la Escala de Graffar. Resultados: Se encontró una prevalencia de sobrepeso (42,6 por ciento) y obesidad (19,1 por ciento). Más de 60 por ciento presentó hábitos alimentarios inadecuados respecto al consumo de carnes (65,2 por ciento), lácteos (78,3 por ciento), menestras (87,8 por ciento), frutas y verduras (64,3 por ciento). Los adultos mayores se ubicaron principalmente en el NSE medio bajo (37 por ciento) y en el NSE medio medio (33 por ciento). El estado nutricional no tuvo una asociación estadísticamente significativa con el NSE (p=0,629), mientras que para los hábitos alimentarios, se observó asociación con el NSE respecto al consumo de carnes (p=0,003), cereales y tubérculos (p=0,038) y de frutas y verduras (p=0,001). Conclusiones: En nuestros sujetos de estudio se evidenció asociación entre los hábitos alimentarios con el NSE, pero no así para con el estado nutricional...
Background: The population of older adults has been increasing in the country. Addressing their problems is complex. They are considered a risk group, with health and nutrition problems related to socioeconomic and other factors. Objectives: To determine the association of dietary habits and nutritional status with socioeconomic status (SES) in older adults attending a Municipal Program. Design: Descriptive, cross-sectional association study. Setting: Municipal Program for Older Adults of 4 districts in Metropolitan Lima, Peru. Participants: Adults of both sexes 60 years or over. Interventions: Weight and height were determined, and previously validated surveys on dietary habits and socioeconomic status were applied to 115 subjects who constantly attended a Municipal Program. Main outcome measures: Nutritional status according to body mass index, adequacy of eating habits according to recommendations, and socioeconomic status by Graffar's scale. Results: Overweight and obesity prevalence were respectively 42.6 per cent and 19.1 per cent. Over 60 per cent had inadequate dietary habits regarding meat (65.2 per cent), dairy (78.3 per cent), beans (87.8 per cent), fruits and vegetables (64.3 per cent). Older adults were located mainly on the medium-low SES (37 per cent) and medium-medium SES (33 per cent). Nutritional status was not significantly associated with SES (p=0.629). Dietary habits were significantly associated (P<0.05) with SES in the consumption of meat (p=0003), cereals and tubers (p=0038), and fruits and vegetables (p=0001). Conclusions: Association of food habits with SES but not with nutritional status was found in our study subject...