Urological Research Centre, Department of Urology, Vejle Hospital, Vejle, Denmark.
Department of Oncology, Vejle Hospital, Vejle, Denmark.
Prostate. 2019 Mar;79(4):425-432. doi: 10.1002/pros.23748. Epub 2018 Dec 9.
Overtreatment is a well-known clinical challenge in local prostate cancer (PCa). Although risk assessment models have contributed to a better stratification of patients with local PCa, a tailored management is still in its infancy. Over the last few decades, microRNAs (miRNAs) have shown promising results as biomarkers in PCa. The aim of this study was to investigate circulating miRNAs after management of local PCa.
The relative expression of four miRNAs (miRNA-21, -93, -125b, and miRNA-221) was assessed in plasma from 149 newly diagnosed patients with local or locally advanced PCa. Real-time polymerase chain reaction was used for analysis. A baseline sample at time of diagnosis and a follow-up sample after 6 months were assessed. The patients were grouped in an interventional cohort (radical prostatectomy, curative intent radiotherapy, or androgen-deprivation therapy alone) and an observational cohort (watchful waiting or active surveillance).
In the interventional cohort, levels of both miRNA-93 and miRNA-221 were significantly lower in the follow-up samples compared to baseline z = -2.738, P = 0.006, and z = -4.498, P < 0.001, respectively. The same observation was recorded for miRNA-125b in the observational cohort (z = -2.656, P = 0.008). Both miRNA-125b and miRNA-221 were correlated with risk assessment r = 0.23, P = 0.015, and r = 0.203, P = 0.016 respectively, while miRNA-93 showed tendency to significant correlation with the prostatectomy Gleason score (r = 0.276, P = 0.0576).
The current results indicate a possible role of miRNA-93 and miRNA-221 in disease monitoring in localized and locally advanced PCa. Larger studies are warranted to assess the clinical impact of these biomarkers.
过度治疗是局部前列腺癌(PCa)的一个众所周知的临床挑战。尽管风险评估模型有助于更好地对局部 PCa 患者进行分层,但个体化管理仍处于起步阶段。在过去几十年中,microRNAs(miRNAs)作为 PCa 的生物标志物显示出了有希望的结果。本研究旨在探讨局部 PCa 治疗后循环 miRNAs 的变化。
采用实时聚合酶链反应检测 149 例新诊断为局部或局部进展性 PCa 的患者血浆中 4 种 miRNA(miRNA-21、-93、-125b 和 miRNA-221)的相对表达。基线样本为诊断时,随访样本为 6 个月后。患者分为干预组(根治性前列腺切除术、根治性放疗或雄激素剥夺治疗)和观察组(观察等待或主动监测)。
在干预组中,与基线相比,随访样本中 miRNA-93 和 miRNA-221 的水平均显著降低(z=-2.738,P=0.006;z=-4.498,P<0.001)。在观察组中也观察到 miRNA-125b 的同样变化(z=-2.656,P=0.008)。miRNA-125b 和 miRNA-221 与风险评估均呈正相关(r=0.23,P=0.015;r=0.203,P=0.016),而 miRNA-93 与前列腺切除术 Gleason 评分呈显著相关(r=0.276,P=0.0576)。
本研究结果表明,miRNA-93 和 miRNA-221 在局部和局部进展性 PCa 的疾病监测中可能具有作用。需要进一步的研究来评估这些生物标志物的临床影响。