Prognostic value of Caveolin-1 in patients treated with radical prostatectomy: a multicentric validation study
Prognostic value of Caveolin-1 in patients treated with radical prostatectomy: a multicentric validation study
复制标题
DOI：
10.1111/bju.13224
复制
发表时间：
2016-08-01
影响因子：
4.5
通讯作者：
Shariat, Shahrokh F.
中科院分区：
文献类型：
--
作者：
Mathieu, Romain;Klatte, Tobias;Shariat, Shahrokh F.
目的在多机构前列腺癌根治术患者中，验证小窝蛋白-1作为前列腺癌生化复发(BCR)的独立预后标记物。单变量和多变量Cox比例风险回归模型评估了Cavelin-1状态与BCR的相关性。结果Caveolin-1在644例(20.6%)患者中过表达，与病理Gleason和(P=0.002)及淋巴结转移有关(P=0.05)。在中位(四分位数范围)38(21-66)个月的随访期内，617名患者(19.8%)经历了BCR。Cavelin-1高表达患者的无bcr生存率低于正常表达患者(Log-ranch检验，P=0.004)。在调整了标准临床病理特征影响的多变量分析中，小窝蛋白-1是bcr的独立预测因子(风险比1.21，P=0.037)。在基于这些标准预测指标的BCR预测模型中加入小窝蛋白-1并没有显著提高模型的预测准确性。在亚组分析中，病理特征良好的患者(pT2pN0和Gleason评分=6；P=0.021)，Caveolin-1的过度表达与BCR有关。结论我们证实Caveolin-1的过度表达与前列腺癌的不良病理特征有关，并可独立预测前列腺癌根治术后的BCR，尤其是在病理特征良好的患者。然而，它没有增加与预后相关的信息，以确定BCR的预测因素，限制了其在临床实践中的使用。
ObjectiveTo validate Caveolin-1 as an independent prognostic marker of biochemical recurrence (BCR) in a large multi-institutional cohort of patients with prostate cancer treated with radical prostatectomy (RP).Patients and MethodsCaveolin-1 expression was evaluated by immunochemistry on a tissue microarray in 3 117 patients treated with RP for prostate cancer at five institutions. Univariable and multivariable Cox proportional hazards regression models assessed the association of Caveolin-1 status with BCR. Harrell's c-index quantified prognostic accuracy.ResultsCaveolin-1 was overexpressed in 644 (20.6%) patients and was associated with higher pathological Gleason sum (P = 0.002) and lymph node metastases (P = 0.05). Within a median (interquartile range) follow-up of 38 (21-66) months, 617 (19.8%) patients experienced BCR. Patients with overexpression of Caveolin-1 had worse BCR-free survival than those with normal expression (log-rank test, P = 0.004). Caveolin-1 was an independent predictor of BCR in multivariable analyses that adjusted for the effects of standard clinicopathological features (hazard ratio 1.21, P = 0.037). Addition of Caveolin-1 in a model for prediction of BCR based on these standard prognosticators did not significantly improve the predictive accuracy of the model. In subgroup analyses, Caveolin-1 was associated with BCR in patients with favourable pathological features (pT2pN0 and Gleason score = 6; P = 0.021).ConclusionsWe confirmed that overexpression of Caveolin-1 is associated with adverse pathological features in prostate cancer and independently predicts BCR after RP, especially in patients with favourable pathological features. However, it did not add prognostically relevant information to established predictors of BCR, limiting its use in clinical practice.