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挽救性放射治疗复发性前列腺癌后GATA2表达与生化复发

GATA2 expression and biochemical recurrence following salvage radiation therapy for relapsing prostate cancer.

作者信息

Robinson Jessica L, Tzou Katherine S, Parker Alexander S, Heckman Michael G, Wu Kevin J, Hilton Tracy W, Pisansky Thomas M, Schild Steven E, Peterson Jennifer L, Vallow Laura A, Buskirk Steven J

机构信息

1 Department of Biology, Edgewood College, Madison, WI, USA.

2 Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA.

出版信息

Br J Radiol. 2017 Jul;90(1075):20170174. doi: 10.1259/bjr.20170174. Epub 2017 Jun 16.

Abstract

OBJECTIVE

High GATA2 expression has been associated with an increased risk of poor clinical outcomes after radical prostatectomy; however, this has not been studied in relation to risk of biochemical recurrence (BCR) after salvage radiation therapy (SRT) for recurrent prostate cancer after radical prostatectomy. Our aim was to evaluate the association between protein expression levels of GATA2 in primary prostate cancer tumour samples and the risk of BCR after SRT.

METHODS

109 males who were treated with SRT were included. The percentage of cells with nuclear staining and GATA2 staining intensity were both measured. These two measures were multiplied together to obtain a GATA2 H-score (range 0-12) which was our primary GATA2 staining measure.

RESULTS

In unadjusted analysis, the risk of BCR was higher for patients with a GATA2 H-score >4 (hazard ratio = 2.04, p = 0.033). In multivariable analysis adjusting for SRT dose, pre-SRT PSA, pathological tumour stage and Gleason score, this association weakened substantially (hazard ratio = 1.45, p = 0.31). This lack of an independent association with BCR appears to be the result of correlations between GATA2 H-score >4 and higher pre-SRT PSA (p = 0.021), higher Gleason score (p = 0.044) and more severe pathological tumour stage (p = 0.068).

CONCLUSION

Higher levels of GATA2 expression appear to be a marker of prostate cancer severity; however, these do not provide independent prognostic information regarding BCR beyond that of validated clinicopathological risk factors. Advances in knowledge: A higher GATA2 expression level appears to be correlated with known measures of prostate cancer severity and therefore is likely not an independent marker of outcome after SRT.

摘要

目的

高GATA2表达与根治性前列腺切除术后临床预后不良风险增加相关;然而,对于根治性前列腺切除术后复发性前列腺癌挽救性放疗(SRT)后生化复发(BCR)风险方面尚未进行研究。我们的目的是评估原发性前列腺癌肿瘤样本中GATA2蛋白表达水平与SRT后BCR风险之间的关联。

方法

纳入109例接受SRT治疗的男性患者。测量细胞核染色细胞的百分比和GATA2染色强度。将这两项指标相乘得到GATA2 H评分(范围0 - 12),这是我们主要的GATA2染色指标。

结果

在未调整分析中,GATA2 H评分>4的患者BCR风险更高(风险比=2.04,p = 0.033)。在对SRT剂量、SRT前前列腺特异性抗原(PSA)、病理肿瘤分期和Gleason评分进行多变量分析时,这种关联大幅减弱(风险比=1.45,p = 0.31)。与BCR缺乏独立关联似乎是由于GATA2 H评分>4与较高的SRT前PSA(p = 0.021)、较高的Gleason评分(p = 0.044)以及更严重的病理肿瘤分期(p = 0.068)之间存在相关性。

结论

较高水平的GATA2表达似乎是前列腺癌严重程度的一个标志物;然而,除了经过验证的临床病理风险因素外,这些指标并不能提供关于BCR的独立预后信息。知识进展:较高的GATA2表达水平似乎与前列腺癌严重程度的已知指标相关,因此可能不是SRT后预后的独立标志物。

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