Fine Noam David, LaPolla Fred, Epstein Matthew, Loeb Stacy, Dani Hasan
Massachusetts General Hospital, Boston, MA, USA.
NYU Health Sciences Library, New York University, New York, NY, USA.
BJU Int. 2019 Oct;124(4):578-586. doi: 10.1111/bju.14799. Epub 2019 Jun 2.
To review systematically the literature on genomic tests for prostate cancer (PCa) and to evaluate the current state of the evidence on their use in patients with newly diagnosed PCa.
We conducted a systematic review by searching PubMed, Embase, Cochrane Central and conference abstracts from the American Urological Association, published between 2010 and 2018. Studies evaluating Prolaris, Oncotype Dx and Decipher assays were assessed for inclusion by two authors. Studies were excluded if the results were derived from surgical specimens rather than biopsy specimens. A meta-analysis was not performed owing to significant variations in methodologies, definitions and outcome measures.
A total of 729 articles were retrieved in our initial search. After removing duplicates (270) and excluding articles deemed not relevant (432), 21 full-text articles were deemed suitable for inclusion in the present analysis. The full-text articles comprised eight studies on Prolaris, eight studies on Oncotype Dx and five studies on Decipher. For each genomic test we extracted data regarding the risks of adverse pathology, biochemical recurrence, metastasis and PCa-specific mortality.
The results of genomic tests that use biomarkers derived from prostate biopsy can be used in conjunction with clinicopathological variables to improve our ability to risk-stratify patients with newly diagnosed PCa. Additional data are needed on the impact of using these tests on long-term patient outcomes and their cost-effectiveness.
系统回顾关于前列腺癌（PCa）基因检测的文献，并评估其在新诊断PCa患者中应用的现有证据状况。
我们通过检索2010年至2018年间发表在PubMed、Embase、Cochrane Central以及美国泌尿外科学会会议摘要上的文献进行系统回顾。两名作者对评估Prolaris、Oncotype Dx和Decipher检测的研究进行纳入评估。如果结果来自手术标本而非活检标本，则排除相关研究。由于方法、定义和结局指标存在显著差异，未进行荟萃分析。
在我们的初步检索中，共检索到729篇文章。去除重复文章（270篇）并排除被认为不相关的文章（432篇）后，21篇全文文章被认为适合纳入本分析。全文文章包括8项关于Prolaris的研究、8项关于Oncotype Dx的研究和5项关于Decipher的研究。对于每项基因检测，我们提取了有关不良病理、生化复发、转移和PCa特异性死亡率风险的数据。
使用前列腺活检衍生生物标志物的基因检测结果可与临床病理变量结合使用，以提高我们对新诊断PCa患者进行风险分层的能力。需要更多关于使用这些检测对患者长期结局的影响及其成本效益的数据。
