Zhao Shankun, Liao Jian, Zhang Shilong, Shen Maolei, Li Xin, Zhou Libo
Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.
Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, China.
Front Oncol. 2023 Feb 14;13:1053111. doi: 10.3389/fonc.2023.1053111. eCollection 2023.
At present, androgen deprivation therapy (ADT) is still the standard regimen for patients with metastatic and locally advanced prostate cancer (PCa). The level of androgen receptor splice variant-7 (AR-V7) in men with castration-resistant prostate cancer (CRPC) has been reported to be elevated compared with that in patients diagnosed with hormone-sensitive prostate cancer (HSPC).
Herein, we performed a systematic review and cumulative analysis to evaluate whether the expression of AR-V7 was significantly higher in patients with CRPC than in HSPC patients.
The commonly used databases were searched to identify the potential studies reporting the level of AR-V7 in CRPC and HSPC patients. The association between CRPC and the positive expression of AR-V7 was pooled by using the relative risk (RR) with the corresponding 95% confidence intervals (CIs) under a random-effects model. For detecting the potential bias and the heterogeneity of the included studies, sensitivity analysis and subgroup analysis were performed. Publication bias was assessed Egger's and Begg's tests. This study was registered on PROSPERO (ID: CRD42022297014).
This cumulative analysis included 672 participants from seven clinical trials. The study group contained 354 CRPC patients, while the other group contained 318 HSPC patients. Pooled results from the seven eligible studies showed that the expression of positive AR-V7 was significantly higher in men with CRPC compared to those with HSPC (RR = 7.55, 95% CI: 4.61-12.35, < 0.001). In the sensitivity analysis, the combined RRs did not change substantially, ranging from 6.85 (95% CI: 4.16-11.27, < 0.001) to 9.84 (95% CI: 5.13-18.87, < 0.001). In the subgroup analysis, a stronger association was detected in RNA hybridization (RISH) measurement in American patients, and those studies were published before 2011 (all < 0.001). There was no significant publication bias identified in our study.
Evidence from the seven eligible studies demonstrated that patients with CRPC had a significantly elevated positive expression of AR-V7. More investigations are still warranted to clarify the association between CRPC and AR-V7 testing.
https://www.crd.york.ac.uk/prospero/, identifier CRD42022297014.
目前，雄激素剥夺疗法（ADT）仍是转移性和局部晚期前列腺癌（PCa）患者的标准治疗方案。据报道，去势抵抗性前列腺癌（CRPC）男性患者中雄激素受体剪接变体7（AR-V7）的水平高于激素敏感性前列腺癌（HSPC）患者。
在此，我们进行了一项系统评价和累积分析，以评估CRPC患者中AR-V7的表达是否显著高于HSPC患者。
检索常用数据库，以确定报告CRPC和HSPC患者中AR-V7水平的潜在研究。在随机效应模型下，使用相对风险（RR）及其相应的95%置信区间（CIs）汇总CRPC与AR-V7阳性表达之间的关联。为检测纳入研究的潜在偏倚和异质性，进行了敏感性分析和亚组分析。采用Egger检验和Begg检验评估发表偏倚。本研究已在PROSPERO注册（ID：CRD42022297014）。
这项累积分析纳入了来自七项临床试验的672名参与者。研究组包括354名CRPC患者，另一组包括318名HSPC患者。七项符合条件的研究的汇总结果显示，CRPC男性患者中AR-V7阳性表达显著高于HSPC患者（RR = 7.55，95% CI：4.61-12.35，P < 0.001）。在敏感性分析中，合并RRs变化不大，范围从6.85（95% CI：4.16-11.27，P < 0.001）到9.84（95% CI：5.13-18.87，P < 0.001）。在亚组分析中，在美国患者的RNA杂交（RISH）测量中检测到更强的关联，且这些研究发表于2011年之前（均P < 0.001）。我们的研究中未发现显著的发表偏倚。
七项符合条件的研究证据表明，CRPC患者中AR-V7的阳性表达显著升高。仍需要更多研究来阐明CRPC与AR-V7检测之间的关联。
