Department of Urology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China.
Clin Transl Oncol. 2020 May;22(5):694-702. doi: 10.1007/s12094-019-02170-3. Epub 2019 Jul 29.
The specific association between PTEN deletion or ERG rearrangement and the recurrence of prostate cancer (PC) treated with radical prostatectomy (RP) or brachytherapy is still unelaborated. Therefore, we performed a comprehensive meta‑analysis to understand the impact of these factors on cancer recurrence.
A comprehensive literature search was performed in November 2018 based on PUBMED, EMBASE and Web of science database. Hazard ratio (HR) for biochemical recurrence free (BRF) which was defined as a PSA greater than or equal to 0.4 ng/mL after RP or another therapy for any detectable PSA and recurrence-free survival (RFS) which defined the time from the beginning of treatment to the earliest occurrence of local recurrence, distant metastasis or death. Which were extracted from eligible studies. I value was used to assess the pooled heterogeneity.
A total of 6744 patients from 17 studies were included in this analysis Overall, The pooled results showed that PTEN loss predict pooled BRF (HR 1.79, 95% CI 1.49-2.16, P < 0.001) and RFS (HR 1.71, 95% CI 1.50-1.95, P < 0.001) in patients after radical prostatectomy or brachytherapy for prostate cancer. Subgroup analysis revealed that PTEN deletion significantly predicted poor BRF or RFS in heterozygous studies group (HR 1.70, 95% CI 1.31-2.21, P < 0.001). The PTEN deletion also significantly predicted poor BRF or PFS in homozygous studies (HR 2.54, 95% CI 1.89-3.17, P < 0.001). And we had found that there was no significant association between ERG rearrangement and cancer recurrence regardless of PTEN loss or not. In addition, we concluded that Gleason score > 6 significantly predicted the poor BRF or RFS in studies, especially in Gleason score = 4 + 3 (HR 3.16, 95% CI 2.08-4.80, P < 0.01).
This study presented that PTEN deletion significantly reduce time of BRF or RFS, especially based on homozygous deletion. And we also found ERG rearrangement in tumor cell could not significantly predict BRF or RFS.
PTEN 缺失或 ERG 重排与接受根治性前列腺切除术（RP）或近距离放射治疗的前列腺癌（PC）复发之间的具体关联仍未阐明。因此，我们进行了一项全面的荟萃分析，以了解这些因素对癌症复发的影响。
我们于 2018 年 11 月在 PUBMED、EMBASE 和 Web of science 数据库中进行了全面的文献检索。无生化复发生存（BRF）的风险比（HR）定义为 RP 或任何可检测 PSA 后 PSA 大于或等于 0.4ng/mL 的生化复发，无复发生存（RFS）定义为从治疗开始到局部复发、远处转移或死亡的最早时间。从合格研究中提取。我们使用 I ²值评估汇总异质性。
共有 17 项研究的 6744 名患者纳入本分析。总体而言，汇总结果显示，PTEN 缺失预测 RP 或近距离放射治疗前列腺癌患者的 BRF（HR 1.79，95%CI 1.49-2.16，P<0.001）和 RFS（HR 1.71，95%CI 1.50-1.95，P<0.001）。亚组分析显示，杂合子研究组中 PTEN 缺失显著预测 BRF 或 RFS 不良（HR 1.70，95%CI 1.31-2.21，P<0.001）。PTEN 缺失在纯合子研究中也显著预测 BRF 或 PFS 不良（HR 2.54，95%CI 1.89-3.17，P<0.001）。我们发现，无论是否存在 PTEN 缺失，ERG 重排与癌症复发之间均无显著关联。此外，我们得出结论，Gleason 评分>6 显著预测研究中的 BRF 或 RFS 不良，尤其是 Gleason 评分=4+3（HR 3.16，95%CI 2.08-4.80，P<0.01）。
本研究表明，PTEN 缺失显著缩短 BRF 或 RFS 时间，尤其是基于纯合缺失。此外，我们还发现肿瘤细胞中的 ERG 重排不能显著预测 BRF 或 RFS。
