基于病理学数据的危险组分层与前列腺癌DX型检测结果相当。

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Archives of pathology & laboratory medicine Pub Date : 2023-10-01 DOI:10.5858/arpa.2022-0225-OA
Pranav S Renavikar, Chad A LaGrange, Subodh M Lele
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引用次数: 0

摘要

上下文。--:针活检诊断的低风险(Gleason评分3+3=6)和中风险(Gleeson评分3+4=7)前列腺癌病例经常被推荐进行基因表达研究,如Oncotype DX,以帮助验证风险。风险评估有助于确定预后和治疗决策。目标。--:通过评估其与病理报告(Gleason评分、分级组、阳性核心比例)和血清前列腺特异性抗原(PSA)水平提供的风险分层的相关性,确定是否有必要增加分子检测。设计。--:我们的机构数据库搜索了前列腺活检后进行肿瘤DX型检测的病例。将分子检测确定的最终风险类别与病理报告和血清PSA水平预测的风险分层进行比较。如果病例属于相同的国家综合癌症网络风险和推荐的初始治疗组,则将其归类为一致。获得不一致病例的随访信息,并用于确定分子检测的风险分层是否优于临床病理数据。结果。--:共筛查了4967例前列腺活检(2015-2020年)。其中,131例前列腺癌病例(2.6%)进行了DX型肿瘤检测,131例病例中有111例(85%)有随访信息。111例患者中有93例(84%)存在风险分层一致性。111例不一致的病例中,所有18例(16%)的随访过程与病理数据和血清PSA预测的风险相匹配。结论。--:病理报告中关于常规活检评估的信息以及血清PSA水平提供的风险分层与通过Oncotype DX检测获得的风险分层相当。
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Pathology Data-Based Risk Group Stratification Is Equivalent to That Obtained by Oncotype DX Testing in Prostatic Adenocarcinoma.

Context.—: Low-risk (Gleason score 3 + 3 = 6) and intermediate-risk (Gleason score 3 + 4 = 7) prostate carcinoma cases diagnosed on needle biopsies are frequently referred for gene expression studies such as Oncotype DX to help validate the risk. Risk assessment helps in determining prognosis and therapeutic decision making.

Objective.—: To determine if addition of molecular testing is necessary, by evaluating its correlation with risk stratification provided by pathology report (Gleason score, Grade Group, proportion of positive cores) and serum prostate-specific antigen (PSA) level.

Design.—: Our institutional database was searched for cases that had Oncotype DX testing after prostate biopsy. The final risk category determined by molecular testing was compared to the risk stratification predicted by the pathology report and serum PSA levels. Cases were classified as concordant if they fell under the same National Comprehensive Cancer Network risk and recommended initial therapy group. Follow-up information on discordant cases was obtained and used to determine if risk stratification by molecular testing was superior to that obtained from the clinicopathologic data.

Results.—: A total of 4967 prostate biopsies (2015-2020) were screened. Of these, 131 prostate carcinoma cases (2.6%) had Oncotype DX testing and 111 of 131 cases (85%) had follow-up information. There was risk stratification concordance in 93 of 111 cases (84%). All 18 of 111 cases (16%) that were discordant had a follow-up course that matched the risk predicted by pathology data and serum PSA.

Conclusions.—: Risk stratification provided by information in the pathology report on routine biopsy assessment coupled with the serum PSA level is equivalent to that obtained by Oncotype DX testing.

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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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