Department of Urology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida.
Department of Radiation Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida.
J Urol. 2021 May;205(5):1344-1351. doi: 10.1097/JU.0000000000001559. Epub 2020 Dec 24.
Genomic prognostic signatures are used on prostate biopsy tissue for cancer risk assessment, but tumor heterogeneity and multifocality may be an issue. We evaluated the variability in genomic risk assessment from different biopsy cores within the prostate using 3 prognostic signatures (Decipher, CCP, GPS).
Men in this study came from 2 prospective prostate cancer trials of patients undergoing multiparametric magnetic resonance imaging and magnetic resonance imaging targeted biopsy with genomic profiling of positive biopsy cores. We explored the relationship among tumor grade, magnetic resonance imaging risk and genomic risk for each signature. We evaluated the variability in genomic risk assessment between different biopsy cores and assessed how often magnetic resonance imaging targeted biopsy or the current standard of care (profiling the core with the highest grade) resulted in the highest genomic risk level.
In all, 224 positive biopsy cores from 78 men with prostate cancer were profiled. For each signature, higher biopsy grade (p <0.001) and magnetic resonance imaging risk level (p <0.001) were associated with higher genomic scores. Genomic scores from different biopsy cores varied with risk categories changing by 21% to 62% depending on which core or signature was used. Magnetic resonance imaging targeted biopsy and profiling the core with the highest grade resulted in the highest genomic risk level in 72% to 84% and 75% to 87% of cases, respectively, depending on the signature used.
There is variation in genomic risk assessment from different biopsy cores regardless of the signature used. Magnetic resonance imaging directed biopsy or profiling the highest grade core resulted in the highest genomic risk level in most cases.
基因组预后标志物用于前列腺活检组织的癌症风险评估，但肿瘤异质性和多灶性可能是一个问题。我们使用 3 种预后标志物（Decipher、CCP、GPS）评估了前列腺内不同活检核心的基因组风险评估的可变性。
本研究中的男性来自 2 项前瞻性前列腺癌试验，这些患者接受多参数磁共振成像和磁共振成像靶向活检，并对阳性活检核心进行基因组分析。我们探讨了每个标志物的肿瘤分级、磁共振成像风险和基因组风险之间的关系。我们评估了不同活检核心之间基因组风险评估的可变性，并评估了磁共振成像靶向活检或当前标准护理（对分级最高的核心进行分析）多少次导致最高的基因组风险水平。
共对 78 名前列腺癌患者的 224 个阳性活检核心进行了分析。对于每个标志物，较高的活检分级（p <0.001）和磁共振成像风险水平（p <0.001）与较高的基因组评分相关。不同活检核心的基因组评分随风险类别而变化，取决于使用的核心或标志物，变化范围为 21%至 62%。磁共振成像靶向活检和分析分级最高的核心分别导致 72%至 84%和 75%至 87%的病例的最高基因组风险水平，具体取决于使用的标志物。
无论使用何种标志物，不同活检核心的基因组风险评估都存在差异。磁共振成像引导的活检或分析分级最高的核心在大多数情况下导致最高的基因组风险水平。
