在接受主动监测的前列腺癌患者中,多基因风险评分和升级
Louisa B Goss1,2, Menghan Liu1, Yingye Zheng1
1Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington.
JAMA oncology
|December 12, 2024
概括
一个高的多基因风险得分 (PRS) 与在积极监测的患者中更高的前列腺癌升级风险有关. 这种遗传风险可能有助于识别那些可以从更密集的监测策略中受益的人.
科学领域:
- 遗传学 是一个遗传学.
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 积极监测是低风险前列腺癌 (PCa) 的标准,但频繁的监测是繁重的.
- 将患者分为密集监测和被动监测的阶层,可以优化护理并减少患者负担.
- 多基因风险评分 (PRS) 可能提供一种工具来识别患有疾病进展风险较高的患者.
研究的目的:
- 检查多基因风险评分 (PRS) 与前列腺癌升级风险之间的关联.
- 在接受主动监测的患者中调查PRS和其他前列腺瘤特征之间的关系.
主要方法:
- 一项前性多中心队列研究包括1220名局部前列腺癌患者在主动监测中.
- 分析了多种祖先的PRS,包括与前列腺特异性抗原 (PSA) 相关的 (PRS-451) 和非相关的 (PRS-400) 变异.
- 主要结局是PCa升级;次要结局包括前列腺体积,PSA和活检结果.
主要成果:
- 较高的PRS与随访期间PCa升级的风险增加显著相关.
- PRS-400显示与更小的前列腺体积和更高的癌症活检核的百分比有关.
- 将PRS-400纳入临床模型略有提高了其对疾病进展的预测能力.
结论:
- 在接受主动监测的患者中,PRS升高与前列腺癌升级和潜在多焦点疾病的风险增加有关.
- 特别是当排除PSA相关变异时,PRS可能会提供关于瘤侵略性的见解,由较小的前列腺大小表明.
- 虽然PRS显示了为主动监测策略提供信息的潜力,但其对临床决策的最终影响需要进一步评估.
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