A Five-Gene Signature and Clinical Outcome in Non–Small-Cell Lung Cancer.pdf

n engl j med 356;1 january 4, 2007 11 The new england journal of medicine established in 1812 january 4, 2007 vol. 356 no. 1 A Five-Gene Signature and Clinical Outcome in Non–Small-Cell Lung Cancer Hsuan-Yu Chen, M.Sc., Sung-Liang Yu, Ph.D., Chun-Houh Chen, Ph.D., Gee-Chen Chang, M.D., Ph.D., Chih-Yi Chen, M.D., Ang Yuan, M.D., Ph.D., Chiou-Ling Cheng, M.Sc., Chien-Hsun Wang, M.Sc., Harn-Jing Terng, Ph.D., Shu-Fang Kao, M.Sc., Wing-Kai Chan, M.D., Han-Ni Li, M.Sc., Chun-Chi Liu, M.Sc., Sher Singh, Ph.D., Wei J. Chen, M.D., Sc.D., Jeremy J.W. Chen, Ph.D., and Pan-Chyr Yang, M.D., Ph.D. A BS TR AC T From National Taiwan University College of Public Health (H.-Y.C., W.J.C.), Nation- al Taiwan University College of Medicine (H.-Y.C., S.-L.Y., C.-L.C., C.-H.W., S.-F.K., H.-N.L., S.S., W.J.C., J.J.W.C., P.-C.Y.), Aca- demia Sinica (C.-H.C, P.-C.Y.), National Taiwan University Hospital (A.Y., W.-K.C., P.-C.Y.), and Advpharma (H.-J.T.) — all in Taipei, Taiwan; and Taichung Veterans General Hospital (G.-C.C., C.-Y.C.) and Na- tional Chung-Hsing University (G.-C.C., C.-C.L., J.J.W.C.) — both in Taichung, Tai- wan. Address reprint requests to Dr. Yang at the Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, Taiwan 100, or at pcyang@.tw. Drs. W.J. Chen, J.J.W. Chen, and P.C. Yang contributed equally to this article. N Engl J Med 2007;356:11-20. Copyright ? 2007 Massachusetts Medical Society. Background Current staging methods are inadequate for predicting the outcome of treatment of non–small-cell lung cancer (NSCLC). We developed a five-gene signature that is closely associated with survival of patients with NSCLC. Methods We used computer-generated random numbers to assign 185 frozen specimens for microarray analysis, real-time reverse-transcriptase polymerase chain reaction (RT-PCR) analysis, or both. We studied gene expression in frozen specimens of lung- cancer tissue from 125 randomly selected p