不畏浮云遮望眼，能发20分杂志的文章，牛逼在何处？

最近从合作医院那里收到这样一条信息。尴尬不，这份清单涵盖了大家所熟知的主流水刊，哦不 sorry，是期刊。物极必反的道理大家都懂，这一现象推广到所有的医院也只是时间问题。当所有

最近从合作医院那里收到这样一条信息。

尴尬不，这份清单涵盖了大家所熟知的主流水刊，哦不sorry，是期刊。

物极必反的道理大家都懂，这一现象推广到所有的医院也只是时间问题。当所有人都在庸庸碌碌做同样的事情的时候，当所有人都在解读3分数据挖掘文章的时候，我并不是说我们不看了，只是，眼光要放长远。

今天为大家带来一篇来自20分杂志JAMA Oncol的文章

JAMA Oncology（IF=20.871）是一个来自北美的顶级期刊，审稿周期长（1-2个月），版费贵（3000美刀左右），自引率低，所有特点都符合牛逼杂志该有的气质。

这篇文章同样可以在桑格助手获得全文浏览(桑格助手公众号使用攻略)

DOI: 10.1001/jamaoncol.2017.1609

我们来看一下这篇文章做了什么：（原文只做大概了解，需要仔细研究下载全文即可）

Abstract

Importance The prevalence of early-stage non–small cell lung cancer (NSCLC) is expected to increase with recent implementation of annual screening programs. Reliable prognostic biomarkers are needed to identify patients at a high risk for recurrence to guide adjuvant therapy.

Objective To develop a robust, individualized immune signature that can estimate prognosis in patients with early-stage nonsquamous NSCLC.

Design, Setting, and Participants This retrospective study analyzed the gene expression profiles of frozen tumor tissue samples from 19 public NSCLC cohorts, including 18 microarray data sets and 1 RNA-Seq data set for The Cancer Genome Atlas (TCGA) lung adenocarcinoma cohort. Only patients with nonsquamous NSCLC with clinical annotation were included. Samples were from 2414 patients with nonsquamous NSCLC, divided into a meta-training cohort (729 patients), meta-testing cohort (716 patients), and 3 independent validation cohorts (439, 323, and 207 patients). All patients underwent surgery with a negative surgical margin, received no adjuvant or neoadjuvant therapy, and had publicly available gene expression data and survival information. Data were collected from July 22 through September 8, 2016.

Main Outcomes and Measures Overall survival.

Results Of 2414 patients (1205 men [50%], 1111 women [46%], and 98 of unknown sex [4%]; median age [range], 64 [15-90] years), a prognostic immune signature of 25 gene pairs consisting of 40 unique genes was constructed using the meta-training data set. In the meta-testing and validation cohorts, the immune signature significantly stratified patients into high- vs low-risk groups in terms of overall survival across and within subpopulations with stage I, IA, IB, or II disease and remained as an independent prognostic factor in multivariate analyses (hazard ratio range, 1.72 [95% CI, 1.26-2.33; P < .001] to 2.36 [95% CI, 1.47-3.79; P < .001]) after adjusting for clinical and pathologic factors. Several biological processes, including chemotaxis, were enriched among genes in the immune signature. The percentage of neutrophil infiltration (5.6% vs 1.8%) and necrosis (4.6% vs 1.5%) was significantly higher in the high-risk immune group compared with the low-risk groups in TCGA data set (P < .003). The immune signature achieved a higher accuracy (mean concordance index [C-index], 0.64) than 2 commercialized multigene signatures (mean C-index, 0.53 and 0.61) for estimation of survival in comparable validation cohorts. When integrated with clinical characteristics such as age and stage, the composite clinical and immune signature showed improved prognostic accuracy in all validation data sets relative to molecular signatures alone (mean C-index, 0.70 vs 0.63) and another commercialized clinical-molecular signature (mean C-index, 0.68 vs 0.65).

Conclusions and Relevance The proposed clinical-immune signature is a promising biomarker for estimating overall survival in nonsquamous NSCLC, including early-stage disease. Prospective studies are needed to test the clinical utility of the biomarker in individualized management of nonsquamous NSCLC.