在临床怀疑患有前列腺癌的男性中,MRI前风险分层的多基因风险得分
Max P Fischer1, Mayer Alena1, Alice Braun1
1Department of Psychiatry-Laboratory for Statistical Genetics, Charité -, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Journal of the National Cancer Institute
|February 2, 2026
概括
多基因风险评分 (PRS) 可以改善前列腺癌 (PCa) 的MRI准确性. 这项研究表明,PRS与年龄相结合,通过识别更多患有癌症可疑发现的男性,提高了MRI利用率.
科学领域:
- 遗传学和基因组学 遗传学和基因组学
- 医疗成像医学成像
- 在瘤学瘤学.
背景情况:
- 前列腺癌 (PCa) 诊断依赖于活检前的MRI.
- 30-50%的MRI是负的 (PI-RADS 1-2),挑战资源利用.
- 在怀疑PCa时优化MRI使用至关重要.
研究的目的:
- 评估PCa多原风险评分 (PRS) 和优化MRI利用的临床标记.
- 确定PRS是否可以改善MRI检测可疑癌症发现的检测.
- 为了识别那些可能避免不必要的MRI扫描的男性.
主要方法:
- 500名疑似PCa的男性接受MRI的前性研究.
- 从唾液DNA计算PCa-PRS;不包括以前PCa或PSA≥25 ng/mL的男性.
- 使用后勤回归和决策曲线分析来构建MRI阳性风险模型 (年龄,PSA,PRS).
主要成果:
- PCa-PRS显著与MRI阳性相关 (OR 1.56,p<.001);单独的PSA没有 (OR 1.17,p=.18).
- 一个具有年龄和PCa-PRS的多变量模型显示了最高的净收益.
- 这种模型增加了14%的MRI阳性男性与单独的PSA相比 (60%对46%,p=.011).
结论:
- 使用PCa-PRS的基因型告知风险分层可以提高MRI效用.
- PCa-PRS有助于识别可疑的癌症发现,改善MRI资源配置.
- 这种方法可能允许选择的个人安全地放弃不必要的MRI扫描.
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