Multiparametric Magnetic Resonance Imaging Features Identify Aggressive Prostate Cancer at the Phenotypic and Transcriptomic Level
Multiparametric Magnetic Resonance Imaging Features Identify Aggressive Prostate Cancer at the Phenotypic and Transcriptomic Level
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DOI：
10.1016/j.juro.2018.06.041
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发表时间：
2018-12-01
影响因子：
6.6
通讯作者：
Tewari, Ashutosh
中科院分区：
文献类型：
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作者：
Beksac, Alp Tuna;Cumarasamy, Shivaram;Tewari, Ashutosh
目的：多参数磁共振成像是前列腺癌的一种诊断工具，但其预后数据有限。我们试图确定多参数磁共振是否可以预测侵袭性前列腺癌features.Materials and Methods：我们回顾性分析了2013年至2017年期间接受根治性前列腺癌切除术的206例患者的记录。所有患者的最终病理学标本上都有可用的RNA表达数据，这些数据是从多参数磁共振成像上对应于病变位置的位置获得的。PIRADS（TM）（前列腺成像报告和数据系统）评分和不良病理学特征之间的关联进行了分析。我们还进行了PIRADS组之间的差异转录组学分析。结果：病变大小（p = 0.03），PIRADS评分（p = 0.02）和前列腺外延伸（p = 0.01）与Decipher（R）评分显著相关。多变量分析显示PIRADS评分（参考PIRADS 3，OR 8.1，95% CI 1.2-57.5，p = 0.04），Gleason分级组前列腺特异性抗原（OR 1.103，95% CI 1.011-1.203）是不良病理结果的危险因素。PIRADS 4和5之间的差异未达到显著性（OR 1.9，95% CI 0.8-4.5，p = 0.12）。PI 3 K-AKT-mTOR、WNT-β和E2 F信号通路在PIRADS 5例中比PIRADS 4例中更活跃。结论：PIRADS评分与不良病理结果、转移风险增加和差异基因通路激活相关。
Purpose: Multiparametric magnetic resonance imaging is a diagnostic tool for prostate cancer with limited data on prognostic use. We sought to determine whether multiparametric magnetic resonance could predict aggressive prostate cancer features.Materials and Methods: We retrospectively analyzed the records of 206 patients who underwent radical prostatectomy between 2013 and 2017. All patients had available RNA expression data on the final pathology specimen obtained from a location corresponding to a lesion location on multiparametric magnetic resonance imaging. The association between the PIRADS (TM) (Prostate Imaging Reporting and Data System) score and adverse pathology features were analyzed. We also performed differential transcriptomic analysis between the PIRADS groups. Factors associated with adverse pathology were analyzed using a multivariable logistic regression model.Results: Lesion size (p = 0.03), PIRADS score (p = 0.02) and extraprostatic extension (p = 0.01) associated significantly with the Decipher (R) score. Multivariable analysis showed that the PIRADS score (referent PIRADS 3, OR 8.1, 95% CI 1.2-57.5, p = 0.04), the Gleason Grade Group (referent 3, OR 5.6, 95% CI 1.5-21.1, p = 0.01) and prostate specific antigen (OR 1.103, 95% CI 1.011-1.203) were risk factors for adverse pathology findings. The difference between PIRADS 4 and 5 did not reach significance (OR 1.9, 95% CI 0.8-4.5, p = 0.12). However, the PI3K-AKT-mTOR, WNT-beta and E2F signaling pathways were more active in PIRADS 5 than in PIRADS 4 cases.Conclusions: The PIRADS score is associated with adverse pathology results, increased metastatic risk and differential genomic pathway activation.