Artikel ; Online: Histomic and transcriptomic features of MRI-visible and invisible clinically significant prostate cancers are associated with prognosis.
International journal of cancer
2023 Band 154, Heft 5, Seite(n) 926–939
Abstract: Magnetic resonance imaging (MRI) is increasingly used to triage patients for prostate biopsy. However, 9% to 24% of clinically significant (cs) prostate cancers (PCas) are not visible in MRI. We aimed to identify histomic and transcriptomic determinants ... ...
| Abstract | Magnetic resonance imaging (MRI) is increasingly used to triage patients for prostate biopsy. However, 9% to 24% of clinically significant (cs) prostate cancers (PCas) are not visible in MRI. We aimed to identify histomic and transcriptomic determinants of MRI visibility and their association to metastasis, and PCa-specific death (PCSD). We studied 45 radical prostatectomy-treated patients with csPCa (grade group [GG]2-3), including 30 with MRI-visible and 15 with MRI-invisible lesions, and 18 men without PCa. First, histological composition was quantified. Next, transcriptomic profiling was performed using NanoString technology. MRI visibility-associated differentially expressed genes (DEGs) and Reactome pathways were identified. MRI visibility was classified using publicly available genes in MSK-IMPACT and Decipher, Oncotype DX, and Prolaris. Finally, DEGs and clinical parameters were used to classify metastasis and PCSD in an external cohort, which included 76 patients with metastatic GG2-4 PCa, and 84 baseline-matched controls without progression. Luminal area was lower in MRI-visible than invisible lesions and low luminal area was associated with short metastasis-free and PCa-specific survival. We identified 67 DEGs, eight of which were associated with survival. Cell division, inflammation and transcriptional regulation pathways were upregulated in MRI-visible csPCas. Genes in Decipher, Oncotype DX and MSK-IMPACT performed well in classifying MRI visibility (AUC = 0.86-0.94). DEGs improved classification of metastasis (AUC = 0.69) and PCSD (AUC = 0.68) over clinical parameters. Our data reveals that MRI-visible csPCas harbor more aggressive histomic and transcriptomic features than MRI-invisible csPCas. Thus, targeted biopsy of visible lesions may be sufficient for risk stratification in patients with a positive MRI. |
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| Mesh-Begriff(e) | Male ; Humans ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/genetics ; Prostatic Neoplasms/surgery ; Prognosis ; Prostate/pathology ; Magnetic Resonance Imaging/methods ; Gene Expression Profiling ; Retrospective Studies |
| Sprache | Englisch |
| Erscheinungsdatum | 2023-09-28 |
| Erscheinungsland | United States |
| Dokumenttyp | Journal Article |
| ZDB-ID | 218257-9 |
| ISSN | 1097-0215 ; 0020-7136 |
| ISSN (online) | 1097-0215 |
| ISSN | 0020-7136 |
| DOI | 10.1002/ijc.34743 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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