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新型探针面板检测临床标本中体细胞 DNA 拷贝数改变以预测前列腺癌进展的可行性和性能。

Feasibility and performance of a novel probe panel to detect somatic DNA copy number alterations in clinical specimens for predicting prostate cancer progression.

机构信息

Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, Illinois.

Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois.

出版信息

Prostate. 2020 Oct;80(14):1253-1262. doi: 10.1002/pros.24057. Epub 2020 Aug 17.

DOI:10.1002/pros.24057
PMID:32803894
Abstract

BACKGROUND

To assess the feasibility of a novel DNA-based probe panel to detect copy number alterations (CNAs) in prostate tumor DNA and its performance for predicting clinical progression.

METHODS

A probe panel was developed and optimized to measure CNAs in trace amounts of tumor DNA (2 ng) isolated from formalin-fixed paraffin-embedded tissues. Ten genes previously associated with aggressive disease were targeted. The panel's feasibility and performance were assessed in 175 prostate cancer (PCa) patients who underwent radical prostatectomy with a median 10-year follow-up, including 42 men who developed disease progression (either metastasis and/or PCa-specific death). Association with disease progression was tested using univariable and multivariable analyses.

RESULTS

The probe panel detected CNAs in all 10 genes in tumor DNA isolated from either diagnostic biopsies or surgical specimens. A four-gene model (PTEN/MYC/BRCA2/CDKN1B) had the strongest association with disease progression; 64.3% of progressors and 22.5% of non-progressors had at least one CNA in these four genes, odds ratio (OR) (95% confidence interval) = 6.21 (2.77-13.87), P = 8.48E-06. The association with disease progression remained significant after adjusting for known clinicopathological variables. Among the seven progressors of the 65 patients with clinically low-risk disease, three (42.9%) had at least one CNA in these four genes.

CONCLUSIONS

The probe panel can detect CNAs in trace amounts of tumor DNA from biopsies or surgical tissues at the time of diagnosis or surgery. CNAs independently predict metastatic/lethal cancer, particularly among men with clinically low-risk disease at diagnosis. If validated, this may improve current abilities to assess tumor aggressiveness.

摘要

背景

评估一种新型基于 DNA 的探针面板检测前列腺肿瘤 DNA 中拷贝数改变 (CNAs) 的可行性及其预测临床进展的性能。

方法

开发并优化了一个探针面板,以测量从福尔马林固定石蜡包埋组织中分离的痕量肿瘤 DNA(2ng)中的 CNAs。靶向了十个先前与侵袭性疾病相关的基因。在 175 名接受根治性前列腺切除术的前列腺癌 (PCa) 患者中评估了该面板的可行性和性能,中位随访时间为 10 年,其中 42 名患者发生疾病进展(转移和/或 PCa 特异性死亡)。使用单变量和多变量分析测试与疾病进展的关联。

结果

该探针面板在从诊断性活检或手术标本中分离的肿瘤 DNA 中检测到了 10 个基因中的所有 CNAs。一个四基因模型(PTEN/MYC/BRCA2/CDKN1B)与疾病进展的相关性最强;42.9%的进展者和 22.5%的非进展者在这四个基因中至少有一种 CNA,优势比(OR)(95%置信区间)为 6.21(2.77-13.87),P=8.48E-06。在调整了已知的临床病理变量后,与疾病进展的关联仍然显著。在 65 名临床低危疾病患者中有 7 名进展者中,其中 3 名(42.9%)在这四个基因中至少有一种 CNA。

结论

该探针面板可以检测诊断或手术时活检或手术组织中痕量肿瘤 DNA 的 CNAs。CNAs 独立预测转移性/致命性癌症,特别是在诊断时临床低危疾病的男性中。如果得到验证,这可能会提高当前评估肿瘤侵袭性的能力。

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Precision medicine for prostate cancer-improved outcome prediction for low-intermediate risk disease using a six-gene copy number alteration classifier.基于 6 个基因拷贝数改变分类器的精准医学:改善低-中危前列腺癌的预后预测。
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