乳腺導管原位癌的Oncotype DX檢測方法用以檢測導管原位癌病人的局部復發風險。檢測結果有助于篩選低風險的導管原位癌病人，保守手術后行放射治療。檢測的基因包括5個增殖基因、孕激素受體（PR）和GSTM-1。我們的目的是判定導管原位癌的PR、核分裂計數或其它病理特征是否能預測導管原位癌Oncotype DX檢測評分。
我們對46例導管原位癌進行Oncotype DX檢測評分。除常規病理信息外，計數導管原位癌的核分裂象，記錄導管原位癌周圍是否有密集的慢性炎細胞浸潤。我們發現：PR ≥90%(P=0.004)、核分裂計數≤1(P=0.045)、雌激素受體≥90%(P=0.046)、低核級(P<0.0001)與導管原位癌Oncotype DX檢測低評分相關。
導管原位癌周圍密集的慢性炎細胞浸潤與Oncotype DX檢測高評分相關(P=0.034)。PR ≥90%、核分裂象≤1且導管原位癌周圍缺乏密集慢性炎細胞浸潤的病例有13例，Oncotype DX檢測全部為低評分（特異性100%）。?
Correlation of histopathologic features of ductal carcinoma in situ of the breast with the oncotype DX DCIS score.
Knopfelmacher A,Fox J,Lo Y,Shapiro N,Fineberg S
Modern Pathology； Sep 2015; 28 (9): 1152 - 1281:1167-73?
The Oncotype DX Breast Cancer Assay for ductal carcinoma in situ is used to determine local recurrence risk in patients with ductal carcinoma in situ. The results help select patients with low-risk ductal carcinoma in situ who could forgo radiation therapy after conservative surgery.?
The genes assessed include five proliferation genes, progesterone receptor (PR), and GSTM-1. Our objective was to determine if PR, mitotic counting, or any other pathologic feature of ductal carcinoma in situ could predict the Oncotype DX DCIS Score. We identified 46 cases of ductal carcinoma in situ with a Oncotype DX DCIS Score. In addition to information obtained from routine pathology, we counted mitotic figures in the ductal carcinoma in situ and noted presence of dense chronic inflammatory infiltrate surrounding ductal carcinoma in situ.?
We found that PR ≥90% (P=0.004), mitotic count ≤1 (P=0.045), estrogen receptor ≥90% (P=0.046), and low nuclear grade (P<0.0001) were associated with a low score. Dense chronic inflammation surrounding ductal carcinoma in situ was associated with a high score (P=0.034).All 13 cases with PR ≥90%, ≤1 mitotic figure and absence of dense chronic inflammation around ductal carcinoma in situ had a low score (100% specificity).?
A low score was not observed in any case with at least two of the following-negative PR, >1 mitotic figure, and/or presence of dense chronic inflammation around ductal carcinoma in situ (100% specificity). Our study suggests using a combination of PR (≥90% vs negative) with mitotic count in ductal carcinoma in situ (≤1 vs >1) and dense chronic inflammation around ductal carcinoma in situ one could predict the Oncotype DX DCIS score. Mitotic counting and evaluation of immune response might provide prognostic information in ductal carcinoma in situ.