Prostate Cancer Genomic Classifier Relates More Strongly to Gleason Grade Group Than Prostate Imaging Reporting and Data System Score in Multiparametric Prostate Magnetic Resonance Imaging-ultrasound Fusion Targeted Biopsies
| Autor: | Darryl T. Martin, Kamyar Ghabili, Angelique Levi, Peter A. Humphrey, Preston C. Sprenkle |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male Oncology medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Internal medicine Biopsy medicine Carcinoma Data Systems Humans Ultrasonography Interventional Aged medicine.diagnostic_test business.industry Prostatectomy Prostatic Neoplasms Magnetic resonance imaging Genomics Odds ratio Middle Aged medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure 030220 oncology & carcinogenesis Biopsy Large-Core Needle Neoplasm Grading business |
| Zdroj: | Urology. 125:64-72 |
| ISSN: | 0090-4295 |
| Popis: | Objective To assess the association between Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) score, the Decipher score, and histologic grade of carcinoma in biopsy tissue among low- to intermediate-risk prostate cancer patients. Methods MRI-ultrasound targeted biopsy of regions of interest and concurrent 12-core systematic biopsy was performed on men with Gleason grade group (GG) 1 and 2. We compared Decipher score with PI-RADS scores and biopsy Gleason GG. Subgroup analyses were performed to evaluate patients who underwent radical prostatectomy (RP), and men with Decipher testing from a targeted biopsy core. Results One hundred two patients with GG1 and GG2 had biopsy Decipher testing. There was no significant difference in the median Decipher scores among the 3 multiparametric magnetic resonance imaging categories. Patients with GG2 vs GG1 in the setting of PI-RADS 4-5 had higher genomic scores (P = .01), but no significant difference was noted in patients with PI-RADS ≤3. The rate of genomic higher-risk disease on a targeted biopsy from PI-RADS5 was higher in GG2 (75%) vs GG1 (11.1%; P = .01). On multivariable logistic regression analysis, the Decipher score ≥0.45, (odds ratio (OR) 2.71; P = .02), and age (OR 1.11; P = .004) remained significant factors associated with Gleason GG2 on biopsy. Conclusion High-risk genomic classification can be seen across all combinations of PI-RADS categories and Gleason GG1 and GG2, confirming a potential utility for Decipher testing in men with low- to favorable intermediate-risk prostate cancer. The Decipher biopsy genomic test related to Gleason GG independent of PI-RADSv2 score. Confirmatory genomic testing for patients undergoing active surveillance appears more valuable than PI-RADSv2 score. |
| Databáze: | OpenAIRE |
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