现代泌尿外科杂志2024,Vol.29Issue(3) :200-204.DOI:10.3969/j.issn.1009-8291.2024.03.002

基于GSS算法的HRD评分与高危前列腺癌和转移性激素敏感性前列腺癌患者临床病理特征、基因组突变和预后的关系

The relationship between HRD score based on GSS algorithm and clinicopathological characteristics,genomic mutations and prognosis in patients with high-risk and metastatic hormone-sensitive prostate cancer

陈志强 高宇 杜松良 牛少曦 李卓然 贾玉琪 董宇杰 王保军
现代泌尿外科杂志2024,Vol.29Issue(3) :200-204.DOI:10.3969/j.issn.1009-8291.2024.03.002

基于GSS算法的HRD评分与高危前列腺癌和转移性激素敏感性前列腺癌患者临床病理特征、基因组突变和预后的关系

The relationship between HRD score based on GSS algorithm and clinicopathological characteristics,genomic mutations and prognosis in patients with high-risk and metastatic hormone-sensitive prostate cancer

陈志强 1高宇 1杜松良 1牛少曦 1李卓然 1贾玉琪 1董宇杰 1王保军1
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作者信息

  • 1. 解放军总医院第三医学中心泌尿外科医学部,北京 100039
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摘要

目的 分析同源重组修复缺陷(HRD)评分与高危和转移性激素敏感性前列腺癌(mHSPC)患者临床病理特征、基因组突变的关系及对mHSPC患者预后的预测价值.方法 纳入2021年12月-2023年11月在解放军总医院第一医学中心泌尿外科诊治的高危前列腺癌和mHSPC患者127例,进行同源重组修复(HRR)基因测序,并基于基因组疤痕评分(GSS)算法得出HRD评分.分析HRD评分与临床病理特征、基因突变和患者预后之间的关系.结果 127例高危前列腺癌和mHSPC患者的中位HRD评分为1.6(0.8,5.2),30例(23.6%)患者HRD评分≥10,11例(8.7%)患者HRD评分≥20.临床病理特征包括国际泌尿病理协会(ISUP)分级≥4(P=0.044)和转移状态(P=0.008)与高HRD评分相关.存在BRCA、TP53和MYC体系基因突变型患者的HRD评分显著高于野生型基因患者(P<0.05).在mHSPC患者中,HRD评分≥20患者出现生化复发的风险是HRD评分<20患者的12.836倍[OR:12.836(1.332~124.623),P=0.028].结论 HRD评分在高危前列腺癌和mHSPC患者中的基线水平较低;HRD评分高的患者可能倾向于拥有更高的组织学分级(ISUP≥4)和更晚的临床分期.HRD评分作为生化标志物提示不良预后的阈值还需进一步的研究.

Abstract

Objective To statistically analyze the relationship between homologous recombination repair deficiency(HRD)score and clinicopathological characteristics,genomic mutations in patients with high-risk and metastatic hormone-sensitive prostate cancer(mHSPC)and the prognostic predictive value in mHSPC.Methods A total of 127 patients diagnosed with high-risk prostate cancer and mHSPC,treated at the Department of Urology of Chinese PLA General Hospital during Dec.2021 and Nov.2023 were enrolled.Homologous recombination repair(HRR)gene sequencing was performed,and the genomic scar score(GSS)algorithm were conducted to calculate the HRD score.The relationship between HRD scores and clinicopathological features,genomic alterations,and prognosis were analyzed.Results The median HRD score was 1.6(0.8,5.2),30(23.6%)patients'HRD scores ≥10,and 11(8.7%)patients'HRD scores ≥20.Clinicopathological features,including ISUP classification ≥4(P=0.044)and metastatic status(P=0.008)were associated with high HRD score.Patients with mutations in the BRCA,TP53 and MYC systems had significantly higher HRD score than those with wild-type genes(P<0.05).In mHSPC,the risk of biochemical recurrence was 12.836 times higher in patients with HRD score ≥20 than in those with<20[OR:12.836(1.332-124.623),P=0.028].Conclusion Baseline HRD score was lower in patients with high-risk prostate cancer and mHSPC.Patients with high HRD score may have higher histological grading(ISUP≥4)and later clinical stage.Further investigation is needed to determine the threshold of HRD scores as biochemical markers suggestive of a poor prognosis.

关键词

同源重组修复/同源重组修复缺陷/基因组疤痕评分/高危前列腺癌/转移性激素敏感性前列腺癌

Key words

homologous recombination repair/homologous recombination repair deficiency/genomic scar score/high-risk prostate cancer/metastatic hormone-sensitive prostate cancer

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基金项目

国家自然科学基金面上项目(82372704)

出版年

2024
现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
参考文献量21
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