Intermountain Healthcare (JTB), Salt Lake City, Utah; Myriad Genetics, Inc. (JR, WW, ZS, ET, JP, AY, AG, JSL, MB), Salt Lake City, Utah; Department of Surgery, Durham Veterans Affairs Medical Center (SJF, LG), Durham, North Carolina; Department of Surgery (Urology) (SJF, LG), Duke University School of Medicine, Durham, North Carolina; Department of Pathology (SJF), Duke University School of Medicine, Durham, North Carolina; Martini-Clinic, Prostate Cancer Center (PT, MG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Pathology (GS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Intermountain Healthcare (JTB), Salt Lake City, Utah; Myriad Genetics, Inc. (JR, WW, ZS, ET, JP, AY, AG, JSL, MB), Salt Lake City, Utah; Department of Surgery, Durham Veterans Affairs Medical Center (SJF, LG), Durham, North Carolina; Department of Surgery (Urology) (SJF, LG), Duke University School of Medicine, Durham, North Carolina; Department of Pathology (SJF), Duke University School of Medicine, Durham, North Carolina; Martini-Clinic, Prostate Cancer Center (PT, MG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Pathology (GS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Urol. 2014 Aug;192(2):409-14. doi: 10.1016/j.juro.2014.02.003. Epub 2014 Feb 7.
The cell cycle progression score is associated with prostate cancer outcomes in various clinical settings. However, previous studies of men treated with radical prostatectomy evaluated cell cycle progression scores generated from resected tumor tissue. We evaluated the prognostic usefulness of the score derived from biopsy specimens in men treated with radical prostatectomy.
We evaluated the cell cycle progression score in cohorts of patients from the Martini Clinic (283), Durham Veterans Affairs Medical Center (176) and Intermountain Healthcare (123). The score was derived from simulated biopsy (Martini Clinic) or diagnostic biopsy (Durham Veterans Affairs Medical Center and Intermountain Healthcare) and evaluated for an association with biochemical recurrence and metastatic disease.
In all 3 cohorts the cell cycle progression score was associated with biochemical recurrence and metastatic disease. The association with biochemical recurrence remained significant after adjusting for other prognostic clinical variables. On combined analysis of all cohorts (total 582 patients) the score was a strong predictor of biochemical recurrence on univariate analysis (HR per score unit 1.60, 95% CI 1.35-1.90, p=2.4×10(-7)) and multivariate analysis (HR per score unit 1.47, 95% CI 1.23-1.76, p=4.7×10(-5)). Although there were few events (12), the cell cycle progression score was the strongest predictor of metastatic disease on univariate analysis (HR per score unit 5.35, 95% CI 2.89-9.92, p=2.1×10(-8)) and after adjusting for clinical variables (HR per score unit 4.19, 95% CI 2.08-8.45, p=8.2×10(-6)).
The cell cycle progression score derived from a biopsy sample was associated with adverse outcomes after surgery. These results indicate that the score can be used at disease diagnosis to better define patient prognosis and enable more appropriate clinical care.
细胞周期进展评分与各种临床环境下的前列腺癌结局相关。然而，先前接受根治性前列腺切除术治疗的男性的研究评估了来自切除肿瘤组织的细胞周期进展评分。我们评估了从根治性前列腺切除术治疗的男性的活检标本中得出的评分的预后有用性。
我们评估了来自 Martini 诊所（283 例）、达勒姆退伍军人事务医疗中心（176 例）和 Intermountain Healthcare（123 例）的患者队列中的细胞周期进展评分。该评分源自模拟活检（Martini 诊所）或诊断性活检（达勒姆退伍军人事务医疗中心和 Intermountain Healthcare），并评估其与生化复发和转移性疾病的关系。
在所有 3 个队列中，细胞周期进展评分与生化复发和转移性疾病相关。在调整其他预后临床变量后，这种关联仍然具有统计学意义。在所有队列的综合分析中（共 582 例患者），该评分在单因素分析中是生化复发的强预测因子（每单位评分的 HR 为 1.60，95%CI 为 1.35-1.90，p=2.4×10(-7)）和多因素分析（每单位评分的 HR 为 1.47，95%CI 为 1.23-1.76，p=4.7×10(-5)）。尽管事件很少（12 个），但细胞周期进展评分在单因素分析中是转移性疾病的最强预测因子（每单位评分的 HR 为 5.35，95%CI 为 2.89-9.92，p=2.1×10(-8)），并且在调整临床变量后也是如此（每单位评分的 HR 为 4.19，95%CI 为 2.08-8.45，p=8.2×10(-6)）。
从活检样本中得出的细胞周期进展评分与手术后的不良结局相关。这些结果表明，该评分可在疾病诊断时用于更好地定义患者的预后，并为更适当的临床护理提供依据。
