發(fā)表于 J Natl Cancer Inst. 2018 Jul 的文章研究了 STO-3 臨床試驗的 1780 名絕經(jīng)后,，沒有淋巴結(jié)轉(zhuǎn)移的ER陽性的乳腺癌患者,，使用 Rao's quadratic entropy 來量化其中的808個還存有FFPE樣品的病人的ER受體多樣性情況。發(fā)現(xiàn)這些ER陽性的乳腺癌患者的ER異質(zhì)性在 luminal A or luminal B subtype分布沒有明顯區(qū)別,。但是生存分析,，發(fā)現(xiàn)ER的異質(zhì)性分組卻明顯跟生存統(tǒng)計學相關(guān)。
關(guān)于STO-3設(shè)計如下： 
結(jié)果是： A statistically significant difference in long-term survival by high vs low intratumor heterogeneity of ER was seen for all ER-positive patients (P < .001) and for patients with luminal A subtype tumors (P = .01).
病理切片的ER受體情況判斷標準非常嚴格： Ten pathologists (RB, JB, PC, YC, BD, FH, GK, FL, YZ, and AB) at the University of California with expertise in breast diagnostics, as a part of the ATHENA Breast Health network, scored (on whole-tumor sections with microscopes) the percentage of positive breast cancer cells for each ER intensity level (0, +1, +2, or?+?3) compared with established standards, after completing an online training module developed to standardize the distinctions between intensity levels
其中652個樣品進行了Agilent基因表達芯片檢測,，使用PAM50進行分類： (luminal A, luminal B, HER2-enriched, basal-like, normal-like)
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