Association between androgen receptor (AR) expression, Ki-67, and the 21-gene recurrence score in early breast cancer.
Bibliographic record
Abstract
547 Background: AR expression is a favorable prognostic factor in estrogen receptor (ER) positive and ER negative breast cancer. Here we explore the association between AR, Ki67, and the 21-gene recurrence score (RS). We hypothesized that ER-positive breast cancers with high AR expression will be associated with a low Ki67 and RS. Methods: Sequential patients with lymph node negative, ER positive and HER2 negative breast cancer who had surgery at Mount Sinai Hospital, Toronto between January 2010 and October 2013 and in whom the RS was requested were identified. Archival tissue was sectioned and stained for AR (AR441 clone, Dako) and Ki67 (MIB-1 clone, Dako) and then visualized by protein polymer (MACH4, Biocare) and DAB chromogen. AR was scored using the Allred system and Ki67 by manual count (using the Ki67 working group recommendations) by a single pathologist. Associations between RS and AR, age, grade, mitotic score, Ki67, and the extent of ER and progesterone receptor (PgR) expression were assessed using linear regression. Ki67 was assessed as a continuous and dichotomous variable (using a cut off of 14%). Statistical significance of this exploratory study was defined as p<0.10. Results: Seventy cases satisfied criteria for analysis. Median age was 59.5 years, mean tumor size was 1.8 cm (range 0.6-3.9 cm), 24% were grade 1, 66% grade 2 and 10% grade 3. Most tumors had high AR expression (median Allred score = 8, 97% had score ≥4). Median RS was 15 (range 1-53). AR expression showed a modest positive correlation with ER (R=0.37), but no correlation with PgR (R=0.09) or Ki67 (R=-0.18). In univariable analysis, AR (p=0.01), ER (p<0.001) and PgR (p<0.001) had significant negative associations with the RS. Ki67 had a non-significant positive association with RS (p=0.11 and p=0.16 for continuous and cut off analyses, respectively). Age (p=0.93), grade (p=0.40) and mitotic count (p=0.23) showed no association with RS. Multivariable analysis showed similar associations with RS (AR [p=0.07], ER [p=0.05], PgR [p=0.001]). Conclusions: AR is not associated with proliferative index (Ki67) but is associated with lower probability of disease recurrence (Low RS).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".