手术前的尿液沉积物染色体不稳定水平预测尿癌预后
Yidie Ying1, Zhensheng Zhang1, Naidong Xing2
1Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
Urologic oncology
|August 31, 2023
概括
尿沉积物中的染色体不稳定性 (CIN) 可以预测尿癌 (UC) 复发. 将CIN与EORTC模型相结合,可以提高膀癌患者的预后准确度,有助于制定量身定制的后续策略.
科学领域:
- 尿瘤学 尿瘤学
- 癌症基因组学 癌症基因组学
- 预测生物标志物 预测生物标志物
背景情况:
- 泌尿腺癌 (UC) 经常在手术后复发,增加医疗保健成本.
- 染色体不稳定 (CIN) 是已知的UC的标志性特征,并影响患者的预后.
- 准确预测UC复发对于有效的患者管理和治疗规划至关重要.
研究的目的:
- 评估尿沉积物中CIN的预后价值,以预测UC复发.
- 评估单独或与细胞学相结合的CIN在预测疾病复发中的准确性.
- 确定将CIN与欧洲癌症研究和治疗组织 (EORTC) 模型相结合是否可以提高预测能力.
主要方法:
- 有望招募137名UC患者.
- 采集手术前的尿样,用于全基因组测序和细胞学.
- 随访直到疾病复发,分析CIN,细胞学和EORTC模型以确定预测的准确性.
主要成果:
- 在高CIN (CIN-high) 患者中观察到更高的复发率,特别是那些经历过尿道切除膀瘤的患者 (57.89%对34.29%).
- 将细胞学与CIN结合起来,可以改善基于复发风险的患者分层.
- 与单独使用EORTC模型 (0.65) 相比,CIN和EORTC模型的组合显著提高了预测准确性 (哈雷尔C指数:0.71).
结论:
- 手术前的尿中CIN水平为膀癌患者提供了强大的预后价值,特别是在经尿道切除膀瘤后.
- 综合CIN和EORTC得分的预后模型可以帮助患者分层,以优化后续治疗方案.
- 这种方法可能会导致更个性化和更有效的治疗后监测尿癌.
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