基因组分类器和局部前列腺癌的预后:一个系统的审查
Matthew J Boyer1,2, David J Carpenter3, Jeffrey R Gingrich4,5
1Durham VA Health Care System, Durham, NC, USA. matthew.boyer@duke.edu.
Prostate cancer and prostatic diseases
|January 10, 2024
概括
与标准方法相比,像Decipher,GPS和Prolaris这样的基因组分类器在预测前列腺癌复发和死亡率方面提供了适度的改进. 对于当前的治疗时代,需要进一步的研究.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 预测生物标志物 预测生物标志物
背景情况:
- 准确的风险分层对于局部性前列腺癌管理至关重要.
- 现有的临床风险分类可能无法完全捕捉预后细微差别.
- 基因组分类器是改进前列腺癌预后的新兴工具.
研究的目的:
- 系统地评估三种基因组分类器 (Decipher,GPS,Prolaris) 对局部性前列腺癌的预后性能.
- 将这些基因组分类器的能力与标准临床风险分类方案进行比较.
- 评估它们对预测生化复发,转移发展和前列腺癌特异性死亡率的影响.
主要方法:
- 对MEDLINE,Embase和Web of Science数据库的系统分析 (2010年1月至2022年4月).
- 包括前性或后性研究报告局部前列腺癌患者的预后.
- 使用预后研究质量 (QUIPS) 工具进行数据提取和偏差风险评估;通过GRADE评估证据的确定性.
主要成果:
- 总共分析了39项涉及超过1万名患者的研究.
- 基因组分类器 (Decipher,GPS,Prolaris) 在关键结果的预后能力中显示出适度的改善.
- 证据确定性低至非常低,主要是由于回顾性研究设计和治疗/时代异质性.
结论:
- 基因组分类器在局部前列腺癌的预后临床方案上提供了小但一致的增强.
- 这些工具可能有助于临床决策,当治疗选择是不确定的.
- 未来的研究需要来自当前管理时代的数据和预测能力的评估.
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