Wang Zhize, Shen Haixiang, Liang Zhen, Mao Yeqing, Wang Chaojun, Xie Liping
Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000 China.
Cancer Cell Int. 2020 May 6;20:149. doi: 10.1186/s12935-020-01229-4. eCollection 2020.
Accumulating evidence suggests androgen receptor splice variant 7 (AR-V7) may be associated with the prognosis of castration-resistant prostate cancer (CRPC) received novel hormonal therapy while its characteristic and prognosis value in hormonal sensitive prostate cancer is unclear.
We aimed to evaluate the prognostic role of AR-V7 by progression free survival (PFS) and overall survival (OS) in hormonal sensitive prostate cancer (HSPC), and the AR-V7-positive-proportion difference in HSPC and CRPC. A search of PubMed, Embase, and the Web of Science was performed using the keywords prostate cancer, prostate tumor, prostate neoplasm, prostate carcinoma; AR-V7, AR3, androgen receptor splicing variant-7, or androgen receptor-3. Seventeen trials published due December 2019 were enrolled.
AR-V7-positive proportion in CRPC was significantly larger than newly diagnosed prostate cancer (PCa) (odds ratio [OR] 7.06, 95% confidence interval [CI] 2.52-19.83, P < 0.001). Subgroup analyses indicated significantly higher AR-V7-positive proportion in CRPC derived from RNA in situ hybridization (OR 65.23, 95% CI 1.34-3171.43, P = 0.04), exosome RNA (OR 3.88, 95% CI 0.98-15.39, P = 0.05) and tissue RNA (OR 10.89, 95% CI 4.13-28.73, P < 0.001). AR-V7-positive patients had a significantly shorter PFS than those who were AR-V7-negative treated with first-line hormonal therapy (hazard ratio [HR] 3.63, 95% CI 1.85-7.10, P < 0.001) and prostatectomy (HR 2.49, 95% CI 1.33-4.64, P = 0.004). OS (HR 5.59, 95% CI 2.89-10.80, P < 0.001) were better in AR-V7-negative than AR-V7-positive HSPC patients treated with first-line hormonal therapy. The limitations of our meta-analysis were differences in study sample size and design, AR-V7 detection assay, and disease characteristics.
AR-V7-positive proportion was significantly higher in CRPC than that in newly diagnosed PCa. AR-V7 positive HSPC patients portend worse prognosis of first-line hormonal therapy and prostatectomy. Additional studies are warranted to confirm these findings.
越来越多的证据表明，雄激素受体剪接变体7（AR-V7）可能与接受新型激素治疗的去势抵抗性前列腺癌（CRPC）的预后相关，但其在激素敏感性前列腺癌中的特征和预后价值尚不清楚。
我们旨在通过无进展生存期（PFS）和总生存期（OS）评估AR-V7在激素敏感性前列腺癌（HSPC）中的预后作用，以及HSPC和CRPC中AR-V7阳性比例的差异。使用关键词前列腺癌、前列腺肿瘤、前列腺瘤、前列腺癌；AR-V7、AR3、雄激素受体剪接变体-7或雄激素受体-3在PubMed、Embase和科学网进行检索。纳入了截至2019年12月发表的17项试验。
CRPC中AR-V7阳性比例显著高于新诊断的前列腺癌（PCa）（优势比[OR]7.06，95%置信区间[CI]2.52-19.83，P<0.001）。亚组分析表明，在源自RNA原位杂交的CRPC中，AR-V7阳性比例显著更高（OR 65.23，95%CI 1.34-3171.43，P=0.04），在外泌体RNA中（OR 3.88，95%CI 0.98-15.39，P=0.05）以及组织RNA中（OR 10.89，95%CI 4.13-28.73，P<0.001）。AR-V7阳性患者接受一线激素治疗（风险比[HR]3.63，95%CI 1.85-7.10，P<0.001）和前列腺切除术后（HR 2.49，95%CI 1.33-4.64，P=0.004）的PFS明显短于AR-V7阴性患者。接受一线激素治疗的AR-V7阴性HSPC患者比AR-V7阳性患者的OS更好（HR 5.59，95%CI 2.89-10.80，P<0.001）。我们的荟萃分析的局限性在于研究样本量和设计、AR-V7检测方法以及疾病特征方面的差异。
CRPC中AR-V7阳性比例显著高于新诊断的PCa。AR-V7阳性的HSPC患者一线激素治疗和前列腺切除术后的预后较差。需要进一步的研究来证实这些发现。
