Kensler Kevin H, Awasthi Shivanshu, Alshalalfa Mohamed, Trock Bruce J, Freedland Stephen J, Freeman Michael R, You Sungyong, Mahal Brandon A, Den Robert B, Dicker Adam P, Karnes R Jeffrey, Klein Eric A, Lal Priti, Liu Yang, Davicioni Elai, Rayford Walter, Yamoah Kosj, Rebbeck Timothy R
Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Eur Urol Open Sci. 2022 Apr 26;40:19-26. doi: 10.1016/j.euros.2022.03.014. eCollection 2022 Jun.
Socioeconomic and health care utilization factors are major drivers of prostate cancer (PC) mortality disparities in the USA; however, tumor molecular heterogeneity may also contribute to the higher mortality among Black men.
To compare differences in PC subtype frequency and genomic aggressiveness by self-identified race.
Five molecular subtype classifiers were applied for 426 Black and 762 White PC patients in the Decipher Genomics Resource Information Database (GRID).
Differences in subtype frequency and tumor genomic risk (Decipher score >0.6) by race were evaluated using χ tests and multivariable-adjusted logistic regression models.
Subtype frequencies differed by race for four classifiers. Subtypes characterized by the presence of mutations, overexpression, and neuroendocrine differentiation were more common among Black men. and fusion-positive subtypes were more frequent among White men, with no clear differences for subtypes reflecting luminal versus basal lineage. The hypothesized low-risk Kamoun S2 subtype was associated with a lower Decipher score among White men only ( = 0.01 for heterogeneity), while the aggressive You PCS1 subtype was associated with a higher Decipher score among White men only ( = 0.001 for heterogeneity). The Tomlins ERG subtype was associated with a higher Decipher score relative to all other subtypes among Black men, with no association among White men ( = 0.007 for heterogeneity).
The frequency of PC molecular subtypes differed by self-identified race. Additional studies are required to evaluate whether our observations suggest differences in the tumor genomic risk of progression by self-identified race.
We studied five classifiers that identify subtypes of prostate tumors and found that subtypes differed in frequency between Black and White patients. Further research is warranted to evaluate how differences in tumor subtypes may contribute to disparities in prostate cancer mortality.
社会经济和医疗保健利用因素是美国前列腺癌（PC）死亡率差异的主要驱动因素；然而，肿瘤分子异质性也可能导致黑人男性死亡率较高。
比较按自我认定种族划分的PC亚型频率和基因组侵袭性差异。
设计、设置和参与者：对解密基因组学资源信息数据库（GRID）中的426名黑人PC患者和762名白人PC患者应用了五种分子亚型分类器。
使用χ检验和多变量调整逻辑回归模型评估种族间亚型频率和肿瘤基因组风险（解密评分>0.6）的差异。
四种分类器的亚型频率因种族而异。以存在突变、过表达和神经内分泌分化为特征的亚型在黑人男性中更为常见。融合阳性亚型在白人男性中更为频繁，反映管腔与基底谱系的亚型没有明显差异。假设的低风险Kamoun S2亚型仅与白人男性中较低的解密评分相关（异质性P = 0.01），而侵袭性的You PCS1亚型仅与白人男性中较高的解密评分相关（异质性P = 0.001）。Tomlins ERG亚型与黑人男性中所有其他亚型相比，解密评分更高，在白人男性中无关联（异质性P = 0.007）。
PC分子亚型的频率因自我认定的种族而异。需要进一步研究以评估我们的观察结果是否表明按自我认定种族划分的肿瘤基因组进展风险存在差异。
我们研究了五种识别前列腺肿瘤亚型的分类器，发现黑人和白人患者之间亚型频率存在差异。有必要进行进一步研究，以评估肿瘤亚型差异如何导致前列腺癌死亡率差异。
