医学
前列腺癌
PTEN公司
前列腺切除术
激素疗法
肿瘤科
病态的
分级(工程)
接收机工作特性
内科学
前列腺
单变量分析
新辅助治疗
病理
免疫组织化学
腺癌
癌症
多元分析
乳腺癌
生物
细胞凋亡
PI3K/AKT/mTOR通路
生物化学
生态学
作者
Xueli Wang,Mei Qi,Jing Zhang,Xuyang Sun,Hai-dong Guo,Yu Pang,Qian Zhang,Xinyi Chen,Ruifeng Zhang,Zhiyan Liu,Long Liu,Hao Xia,Bo Han
出处
期刊:The Prostate
[Wiley]
日期:2019-03-02
卷期号:79 (7): 709-719
被引量:19
摘要
Objectives The predictive value of the histological parameters and molecular markers for neoadjuvant hormonal therapy (NHT) in prostate cancer (PCa) has not been well established. The aim of this study is to determine pathological variables that can predict differences in response to NHT in PCa. Methods A total of 85 locally high risk PCa patients with matched preoperative needle biopsies and radical prostatectomy (RP) specimens were included. All patients were treated with NHT for at least 3 months. We quantified the response to NHT using a new proposed pathological grading system. The system classified tumors into five groups (grades 0‐4) according to the severity of histological response. We then categorized the PCa patients into drug‐sensitive (DS) group (Grades 2‐4) and drug‐resistant (DR) group (Grades 0‐1). Two pathologists assessed each pretreated tumors for presence or absence of nine morphological features. The expression of androgen receptor (AR), ERG, and PTEN were evaluated by immunohistochemistry (IHC) as well. Statistical analysis was performed to identify significant associations between differentially histological response to NHT and morphological features as well as molecular aberrations. We evaluated different prediction models using receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) analysis. Results 73% ( n = 62/85) of tumors in our cohort belonged to DS group, whereas 27% ( n = 23/85) of tumors were DR. Univariate logistic analysis suggested four pathological variables, cribriform growth pattern, macronucleoli, ductal adenocarcinoma differentiation, and PTEN loss in needle biopsies were significantly associated with DR effect, all with P ‐value < 0.05. Multivariate logistic regression analysis revealed that the three parameters as significant predictive factors for predicting DR effect. These were macronucleoli (RR = 4.008, P = 0.002), ductal adenocarcinoma differentiation (RR = 11.659, P = 0.009) and PTEN loss expression (RR = 7.275, P = 0.015). The AUC of three integrated indicators model was 0.781. Conclusions Our study suggested that the presence of tumor cribriform growth pattern, macronucleoli, ductal adenocarcinoma differentiation, and PTEN loss in needle biopsies are of value in predicting tumor response to NHT regimen. Multivariate logistic regression analysis revealed the performance of combined pathological indicators in predicting DR response was better than that of model based on individual factor alone.
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