Department of Urology, Stanford University School of Medicine, Stanford, California 94305, USA.
J Urol. 2012 Dec;188(6):2158-64. doi: 10.1016/j.juro.2012.08.014. Epub 2012 Oct 22.
AR-V7, a ligand independent splice variant of androgen receptor, may support the growth of castration resistant prostate cancer and have prognostic value. Another variant, AR-V1, interferes with AR-V7 activity. We investigated whether AR-V7 or V1 expression would predict biochemical recurrence in men at indeterminate (about 50%) risk for progression following radical prostatectomy.
AR-V7 and V1 transcripts in a mixed grade cohort of 53 men in whom cancer contained 30% to 70% Gleason grade 4/5 and in a grade 3 only cohort of 52 were measured using a branched chain DNA assay. Spearman rank correlations of the transcripts, and histomorphological and clinical variables were determined. AR-V7 and V1 levels were assessed as determinants of recurrence in the mixed grade cohort by logistic regression and survival analysis. The impact of TMPRSS2-ERG gene fusion on prognosis was also evaluated.
Neither AR-V7 nor V1 levels in grade 3 or 4/5 cancer in the mixed grade cohort were associated with recurrence or time to recurrence. However, AR-V7 and V1 inversely correlated with serum prostate specific antigen and positively correlated with age. The AR-V1 level in grade 3 cancer in the grade 3 only cohort was higher than in grade 3 or grade 4/5 components of mixed grade cancer. TMPRSS2-ERG fusion was not associated with AR-V7, AR-V1 or recurrence but it was associated with the percent of grade 4/5 cancer.
The AR-V1 or V7 transcript level does not predict recurrence in patients with high grade prostate cancer at indeterminate risk for progression. Grade 3 cancer in mixed grade tumors may differ from 100% grade 3 cancer, at least in AR-V1 expression.
雄激素受体(AR)的无配体剪接变体 AR-V7 可能支持去势抵抗性前列腺癌的生长,并具有预后价值。另一种变体 AR-V1 会干扰 AR-V7 的活性。我们研究了 AR-V7 或 V1 的表达是否会预测在根治性前列腺切除术后进展风险不确定(约 50%)的男性中发生生化复发的情况。
使用分支 DNA 分析检测了 53 名混合分级队列(癌症中包含 30%至 70%Gleason 分级 4/5 级和 52 名仅 3 级队列)中男性的 AR-V7 和 V1 转录物。确定了转录物与组织形态学和临床变量之间的 Spearman 秩相关。通过逻辑回归和生存分析评估混合分级队列中 AR-V7 和 V1 水平作为复发的决定因素。还评估了 TMPRSS2-ERG 基因融合对预后的影响。
在混合分级队列中,3 级或 4/5 级癌症中的 AR-V7 或 V1 水平均与复发或复发时间无关。然而,AR-V7 和 V1 与血清前列腺特异性抗原呈负相关,与年龄呈正相关。在仅 3 级队列中,3 级癌症的 AR-V1 水平高于混合分级癌症的 3 级或 4/5 级成分。TMPRSS2-ERG 融合与 AR-V7、AR-V1 或复发无关,但与 4/5 级癌症的百分比有关。
在进展风险不确定的高级别前列腺癌患者中,AR-V1 或 V7 转录本水平不能预测复发。混合肿瘤中的 3 级癌症可能与 100%的 3 级癌症不同,至少在 AR-V1 表达方面。