Department of Urology, National Cancer Center Hospital, Tokyo, Japan.
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Prostate. 2022 Dec;82(16):1537-1546. doi: 10.1002/pros.24427. Epub 2022 Aug 16.
Although radical prostatectomy is associated with good long-term oncological outcomes, approximately 30% of patients present biochemical recurrence, whereupon salvage treatments are required. Identification of novel molecular biomarkers to predict cancer behavior is clinically important. Here, we developed a novel microRNA (miRNA)-based prognostic model for patients who underwent radical prostatectomy.
We retrospectively investigated the clinical records of 295 patients who underwent radical prostatectomy between 2009 and 2017. We randomly assigned these cases into training or validation sets. The prognostic model was constructed using Fisher linear discriminant analysis in the training set, and we evaluated its performance in the validation set.
Overall, 72 patients had biochemical recurrence. A prediction model was constructed using a combination of three miRNAs (miR-3147, miR-4513, and miR-4728-5p) and two pathological factors (pathological T stage and Gleason score). In the validation set, the predictive performance of the model was confirmed to be accurate (area under the receiver operating characteristic curve: 0.80; sensitivity: 0.78; specificity: 0.76). Additionally, Kaplan-Meier analysis revealed that the patients with a low prediction index had significantly longer recurrence-free survival than those with a high index (p < 0.001).
Circulating miRNA profiles can provide information to predict recurrence after prostatectomy. Our model may be helpful for physicians to decide follow-up strategies for patients.
尽管根治性前列腺切除术与良好的长期肿瘤学结果相关,但约 30%的患者出现生化复发,此时需要进行挽救治疗。鉴定新的分子生物标志物以预测癌症行为具有重要的临床意义。在这里,我们开发了一种新的基于 microRNA(miRNA)的预后模型,用于接受根治性前列腺切除术的患者。
我们回顾性地调查了 295 例 2009 年至 2017 年期间接受根治性前列腺切除术的患者的临床记录。我们将这些病例随机分配到训练集或验证集中。使用训练集中的 Fisher 线性判别分析构建预后模型,并在验证集中评估其性能。
总体而言,有 72 例患者出现生化复发。使用三个 miRNA(miR-3147、miR-4513 和 miR-4728-5p)和两个病理因素(病理 T 分期和 Gleason 评分)构建了一个预测模型。在验证集中,该模型的预测性能被证实是准确的(接收者操作特征曲线下面积:0.80;灵敏度:0.78;特异性:0.76)。此外,Kaplan-Meier 分析表明,预测指数低的患者的无复发生存率明显长于指数高的患者(p<0.001)。
循环 miRNA 谱可以提供有关前列腺切除术后复发的信息。我们的模型可能有助于医生为患者制定随访策略。