Roidos Christos, Anastasiadis Anastasios, Tsiakaras Stavros, Loutradis Charalampos, Baniotis Panagiotis, Memmos Dimitrios, Dimitriadis Georgios, Papaioannou Maria
First Department of Urology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Laboratory of Biological Chemistry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Curr Issues Mol Biol. 2024 Dec 20;46(12):14408-14421. doi: 10.3390/cimb46120864.
Prostate cancer (PCa) is a common malignancy in men and is among the leading causes of cancer-related death worldwide. Genomic tests assess disease aggressiveness and guide treatment, particularly in low- and intermediate-risk PCa. We reviewed the literature on the use of four genomic tests (Prolaris, Promark, Oncotype DX, and Decipher) in assessing the prognosis of PCa and their use in treatment decision-making. Most of the studies showed that Prolaris has a strong correlation with biochemical recurrence, metastasis risk, PCa-specific mortality (PCSM), and pathological features. Similarly, three studies on Promark indicated a connection between results and pathological features in the subsequent prostatectomy, time to metastasis, and biochemical recurrence. Fourteen studies on Oncotype DX showed a clear correlation between high scores, death, and PCSM. One study found that routine biopsy pathology reports, combined with serum PSA levels, provide a risk assessment comparable to Oncotype DX testing. Results from 22 studies on Decipher were controversial. The test was associated with conservative management, suggesting that patients with a high GC score are more likely to need radiation after surgery. Comparative studies indicated that Oncotype DX is preferable for assessing PCSM, Decipher for predicting metastasis, and Prolaris for predicting recurrence. With the incidence rate of PCa dramatically increasing, genomic tests appear to be useful adjunctive precision medicine tools with significant potential in improving prognostic discrimination, facilitating better risk stratification, and guiding personalized treatment, especially in the intermediate-risk patient group. Large-scale, prospective, multi-sectional studies are required to validate the utility of these tests prior to their integration into clinical practice.
前列腺癌（PCa）是男性常见的恶性肿瘤，也是全球癌症相关死亡的主要原因之一。基因组检测可评估疾病的侵袭性并指导治疗，尤其是在低风险和中风险前列腺癌中。我们回顾了关于使用四种基因组检测（Prolaris、Promark、Oncotype DX和Decipher）评估前列腺癌预后及其在治疗决策中的应用的文献。大多数研究表明，Prolaris与生化复发、转移风险、前列腺癌特异性死亡率（PCSM）和病理特征密切相关。同样，三项关于Promark的研究表明，检测结果与后续前列腺切除术中的病理特征、转移时间和生化复发之间存在关联。十四项关于Oncotype DX的研究表明，高分与死亡及PCSM之间存在明显关联。一项研究发现，常规活检病理报告结合血清PSA水平可提供与Oncotype DX检测相当的风险评估。22项关于Decipher的研究结果存在争议。该检测与保守治疗相关，表明GC评分高的患者术后更有可能需要放疗。比较研究表明，Oncotype DX在评估PCSM方面更具优势，Decipher在预测转移方面更具优势，而Prolaris在预测复发方面更具优势。随着前列腺癌发病率的急剧上升，基因组检测似乎是有用的辅助精准医学工具，在改善预后判别、促进更好的风险分层以及指导个性化治疗方面具有巨大潜力，尤其是在中风险患者群体中。在将这些检测整合到临床实践之前，需要进行大规模、前瞻性、多中心研究以验证其效用。
