Assessing the Optimal Cutpoint for Tumor Size in Patients with Lung Cancer Based on Linear Rank Statistics in a Competing Risks Framework

PURPOSE: In clinical studies, patients may experience several types of events during follow up under the competing risks (CR) framework. Patients are often classified into low- and high-risk groups based on prognostic factors. We propose a method to determine an optimal cutpoint value for prognostic factors on censored outcomes in the presence of CR. MATERIALS AND METHODS: We applied our method to data collected in a study of lung cancer patients. From September 1, 1991 to December 31, 2005, 758 lung cancer patients received tumor removal surgery at Samsung Medical Center in Korea. The proposed statistic converges in distribution to that of the supremum of a standardized Brownian bridge. To overcome the conservativeness of the test based on an approximation of the asymptotic distribution, we also propose a permutation test based on permuted samples. RESULTS: Most cases considered in our simulation studies showed that the permutation-based test satisfied a significance level of 0.05, while the approximation-based test was very conservative: the powers of the former were larger than those of the latter. The optimal cutpoint value for tumor size (unit: cm) prior to surgery for classifying patients into two groups (low and high risks for relapse) was found to be 1.8, with decent significance reflected as p values less than 0.001. CONCLUSION: The cutpoint estimator based on the maximally selected linear rank statistic was reasonable in terms of bias and standard deviation in the CR framework. The permutation-based test well satisfied type I error probability and provided higher power than the approximation-based test.

Rank-Based Nonlinear Normalization of Oligonucleotide Arrays

MOTIVATION: Many have observed a nonlinear relationship between the signal intensity and the transcript abundance in microarray data. The first step in analyzing the data is to normalize it properly, and this should include a correction for the nonlinearity. The commonly used linear normalization schemes do not address this problem. RESULTS: Nonlinearity is present in both cDNA and oligonucleotide arrays, but we concentrate on the latter in this paper. Across a set of chips, we identify those genes whose within-chip ranks are relatively constant compared to other genes of similar intensity. For each gene, we compute the sum of the squares of the differences in its within-chip ranks between every pair of chips as our statistic and we select a small fraction of the genes with the minimal changes in ranks at each intensity level. These genes are most likely to be non-differentially expressed and are subsequently used in the normalization procedure. This method is a generalization of the rank-invariant normalization (Li and Wong, 2001), using all available chips rather than two at a time to gather more information, while using the chip that is least likely to be affected by nonlinear effects as the reference chip. The assumption in our method is that there are at least a small number of nondifferentially expressed genes across the intensity range. The normalized expression values can be substantially different from the unnormalized values and may result in altered down-stream analysis.