Prognostic Utility of a New mRNA Expression Signature of Gleason Score

Autor: Sam Peisch, Michelangelo Fiorentino, Kathryn L. Penney, Lorelei A. Mucci, Massimo Loda, Jennifer A. Sinnott, Jennifer R. Rider, Meir J. Stampfer, Rosina T. Lis, Svitlana Tyekucheva, Travis Gerke
Přispěvatelé: Sinnott JA, Peisch S, Tyekucheva S, Gerke TA, Lis RT, Rider JR, Fiorentino M, Stampfer MJ, Mucci LA, Loda M, Penney KL.
Rok vydání: 2017
Předmět:
Zdroj: Clinical Cancer Research. 23:81-87
ISSN: 1557-3265
1078-0432
Popis: Purpose: Gleason score strongly predicts prostate cancer mortality; however, scoring varies among pathologists, and many men are diagnosed with intermediate-risk Gleason score 7. We previously developed a 157-gene signature for Gleason score using a limited gene panel. Using a new whole-transcriptome expression dataset, we verified the previous signature's performance and developed a new Gleason signature to improve lethal outcome prediction among men with Gleason score 7. Experimental Design: We generated mRNA expression data from prostate tumor tissue from men in the Physicians' Health Study and Health Professionals Follow-Up Study (N = 404) using the Affymetrix Human Gene 1.0 ST microarray. The Prediction Analysis for Microarrays method was used to develop a signature to distinguish high (≥8) versus low (≤6) Gleason score. We evaluated the signature's ability to improve prediction of lethality among men with Gleason score 7, adjusting for 3 + 4/4 + 3 status, by quantifying the area under the receiver operating characteristic (ROC) curve (AUC). Results: We identified a 30-gene signature that best distinguished Gleason score ≤6 from ≥8. The AUC to predict lethal disease among Gleason score 7 men was 0.76 [95% confidence interval (CI), 0.67–0.84] compared with 0.68 (95% CI, 0.59–0.76) using 3 + 4/4 + 3 status alone (P = 0.0001). This signature was a nonsignificant (P = 0.09) improvement over our previous signature (AUC = 0.72). Conclusions: Our new 30-gene signature improved prediction of lethality among men with Gleason score 7. This signature can potentially become a useful prognostic tool for physicians to improve treatment decision making. Clin Cancer Res; 23(1); 81–87. ©2016 AACR. See related commentary by Yin et al., p. 6
Databáze: OpenAIRE