Department of Urology, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA.
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA.
Prostate Cancer Prostatic Dis. 2017 Dec;20(4):430-435. doi: 10.1038/pcan.2017.33. Epub 2017 Aug 1.
Multiparametric magnetic resonance imaging (mpMRI) has been increasingly used for prostate cancer (PCa). Recent studies identified distinct molecular subclasses of PCa with recurrent genomic alterations. However, the associations between molecular alterations in PCa and characteristics on mpMRI are unknown. Therefore, the objective of this study was to investigate recurrent molecular alterations in PCa and their associations with mpMRI features.
Sixty-two PCa nodules >0.5 cm had a preoperative mpMRI. Nodules were evaluated for ERG rearrangement, PTEN deletion, SPINK1 overexpression, SPOP mutation and CHD1 deletion. Each PCa focus was matched to the corresponding location on mpMRI. Lesions were scored by single observer according to the PI-RADSv2 scale.
Of the 62 nodules, 22 (35.5%) were ERG positive, 6 (9.7%) had SPINK1 overexpression, 6 (9.7%) had SPOP mutations, 4 (6.5%) had CHD1 deletions and 1 (1.6%) had PTEN deletion. All of the nodules with CHD1 deletions were not visible on mpMRI (P=0.037). All of the nodules with SPINK1 overexpression were visible on mpMRI, although the association was not statistically significant (P=0.06). There were no significant associations between any molecular alteration with the severity of the PI-RADS scores (all P>0.05).
This investigation represents the first description of an association between recurrent molecular alterations and the characterization of PCa nodules on mpMRI. This study can be considered hypothesis-generating for future studies to rigorously evaluate the association of specific PCa molecular subclasses with imaging features and potentially define specific subsets of PCa for which the utility of MRI is higher or lower.
多参数磁共振成像（mpMRI）已越来越多地用于前列腺癌（PCa）。最近的研究确定了具有复发性基因组改变的 PCa 的不同分子亚型。然而，PCa 中的分子改变与 mpMRI 特征之间的关联尚不清楚。因此，本研究的目的是研究 PCa 中的复发性分子改变及其与 mpMRI 特征的关联。
62 个>0.5cm 的 PCa 结节进行了术前 mpMRI。评估结节是否存在 ERG 重排、PTEN 缺失、SPINK1 过表达、SPOP 突变和 CHD1 缺失。每个 PCa 病灶均与 mpMRI 上的相应位置相匹配。病变由单一观察者根据 PI-RADSv2 量表进行评分。
在 62 个结节中，22 个（35.5%）为 ERG 阳性，6 个（9.7%）存在 SPINK1 过表达，6 个（9.7%）存在 SPOP 突变，4 个（6.5%）存在 CHD1 缺失，1 个（1.6%）存在 PTEN 缺失。所有 CHD1 缺失的结节在 mpMRI 上均不可见（P=0.037）。所有 SPINK1 过表达的结节在 mpMRI 上均可见，但相关性无统计学意义（P=0.06）。任何分子改变与 PI-RADS 评分的严重程度之间均无显著关联（均 P>0.05）。
本研究首次描述了复发性分子改变与 mpMRI 上 PCa 结节特征之间的关联。该研究可以为未来的研究提供假设，以严格评估特定 PCa 分子亚型与影像学特征的关联，并可能为 MRI 应用价值更高或更低的特定 PCa 亚组提供定义。
