A novel application of Decipher testing in HoLEP specimens for risk stratification of incidentally detected prostate cancer.

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-10-01 DOI:10.1016/j.urology.2025.09.047

Nicole Handa, Harsha Kaul, Clayton Neill, James A Proudfoot, Ridwan Alam, Mitchell M Huang, Elai Davicioni, Edward M Schaeffer, Amy E Krambeck, Ashley E Ross

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引用次数: 0

Abstract

Objectives: To assess the feasibility of Decipher testing for prostate cancer incidentally identified on specimens from holmium laser enucleation of the prostate (HoLEP). Additionally, we sought to review Decipher GRID expression signatures in cancers identified on HoLEP compared to those identified on prostate biopsy.

Methods: We identified patients who had prostate cancer on HoLEP at our institution from August 2021-July 2024 and subsequently underwent Decipher testing. Quality assurance testing was performed and transcriptomic signature expression patterns between HoLEP specimens and Grade Group (GG)-matched biopsy specimens were compared using standard mean differences (SMD).

Results: Of the 38 HoLEP specimens that underwent Decipher testing, 2 (5.3%) failed quality assurance testing due to lack of sufficient tumor present in the sample. Compared to GG-matched biopsy specimens (N=58,500), the HoLEP group (N=36) had similar median Decipher scores (0.56 vs 0.45, SMD 0.33) and lower median PSA (3.1 vs 6.2). HoLEP specimens were enriched for lower androgen receptor activity (SMD 0.63), basal subtypes by both PAM50 (SMD 1.23) and PSC (SMD 1.09), and ERG negative status (SMD 0.86). HoLEP specimens also had higher expression of activated CD4 (SMD 1.06), tertiary lymphoid structure (SMD 1.40), and angiogenesis (SMD 1.27).

Conclusion: Decipher testing for HoLEP specimens is feasible, although clinical utility remains unclear. Compared to biopsy specimens, HoLEP specimens have increased immune and angiogenesis-related signature expression and lower AR-A expression suggesting that these tumors have unique microenvironments.

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在偶然发现前列腺癌的HoLEP标本中进行风险分层的新应用破译测试。

目的：探讨钬激光前列腺摘除（HoLEP）标本中偶然发现的前列腺癌的破译检测的可行性。此外，我们试图审查在HoLEP鉴定的癌症中与前列腺活检鉴定的癌症相比，破译GRID表达特征。方法：我们从2021年8月至2024年7月在我们的机构确定了HoLEP中患有前列腺癌的患者，随后进行了破译测试。进行质量保证测试，并使用标准平均差异（SMD）比较HoLEP标本和分级组（GG）匹配的活检标本之间的转录组特征表达模式。结果：38例HoLEP标本中，2例（5.3%）由于样本中缺乏足够的肿瘤存在而未能通过质量保证测试。与gg匹配的活检标本（N=58,500）相比，HoLEP组（N=36）具有相似的中位破译评分（0.56 vs 0.45, SMD 0.33）和更低的中位PSA （3.1 vs 6.2）。HoLEP标本雄激素受体活性较低（SMD 0.63）， PAM50 （SMD 1.23）和PSC （SMD 1.09）为基础亚型，ERG为阴性（SMD 0.86）。HoLEP标本的活化CD4 （SMD 1.06）、三级淋巴结构（SMD 1.40）和血管生成（SMD 1.27）的表达也较高。结论：破译检测HoLEP标本是可行的，尽管临床用途尚不清楚。与活检标本相比，HoLEP标本的免疫和血管生成相关特征表达增加，AR-A表达降低，表明这些肿瘤具有独特的微环境。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.