背景:研究表明,AR-V7可能与去势抵抗性前列腺癌(CRPC)的不良预后有关,然而,AR-V7的临床病理特征尚未完全阐明。
目的:本研究旨在评估CRPC患者AR-V7的临床病理特征。
方法:评价CRPC患者AR-V7的临床病理特征。搜索PubMed,Embase,WebofScience是用关键词前列腺癌进行的,前列腺肿瘤,前列腺肿瘤,前列腺癌,AR-V7、AR3、雄激素受体剪接变体-7或雄激素受体-3。到2020年2月发表的24项试验包括在这项研究中。
结果:发现AR-V7阳性CRPC的Gleason评分≥8的比例(69.5%)明显高于阴性(54.9%)(OR1.68,95%CI1.25-2.25,p<0.001),而T3/T4阶段(OR1.16,95%CI0.60-2.24,p=0.65)和N1阶段(OR0.99,95%CI0.65-1.51,p=0.96)的比率与AR-V7状态无统计学相关性。AR-V7阳性患者的任何部位转移(61.3%对35.0%;OR2.19,95%CI1.57-3.05,p<0.001)和骨转移(81.7%对69.0%;OR1.97,95%CI1.44-2.69,p<0.001),预计内脏转移的趋势接近显著性(28.8%对22.1%;OR1.29,95%CI0.96-1.74,p=0.09)。AR-V7阳性CRPC的疼痛发生率(54.6%)明显高于阴性CRPC(28.1%;OR4.23,95%CI2.52-7.10,p<0.001),ECOG表现状况较差(56.7%对35.0%,OR2.18,95%CI1.51-3.16,P<0.001)。研究的局限性包括样本量和设计的差异,AR-V7检测分析,以及纳入研究的疾病特征。
结论:AR-V7阳性与较高的格里森评分相关,骨或任何部位转移,CRPC中的疼痛和ECOG表现评分较差。然而,与肿瘤分期或淋巴结转移无关。需要更多的研究来证实这些发现。
BACKGROUND: Studies have shown that AR-V7 may be correlated with the poor prognosis of castration resistant prostate cancer (CRPC), however, clinicopathological characteristics of AR-V7 have not been fully elucidated.
OBJECTIVE: This study aimed at evaluating the clinicopathological features of AR-V7 in CRPC patients.
METHODS: To evaluate the clinicopathological features of AR-V7 in CRPC patients. A search of PubMed, Embase, and Web of Science was performed using the keywords prostate cancer, prostate tumor, prostate neoplasm, prostate carcinoma, AR-V7, AR3, androgen receptor splicing variant-7, or androgen receptor-3. Twenty-four trials published by February 2020 were included in this study.
RESULTS: The proportion of Gleason score ≥ 8 was found to be significantly higher in AR-V7-positive CRPC (69.5%) than negative (54.9%) (OR 1.68, 95% CI 1.25-2.25, p < 0.001), while the rates of T3/T4 stage (OR 1.16, 95% CI 0.60-2.24, p = 0.65) and N1 stage (OR 0.99, 95% CI 0.65-1.51, p = 0.96) were not statistically correlated with AR-V7 status. The AR-V7-positive patients exhibited a significantly higher proportion of any site metastasis (61.3% versus 35.0%; OR 2.19, 95% CI 1.57-3.05, p < 0.001) and bone metastasis (81.7% versus 69.0%; OR 1.97, 95% CI 1.44-2.69, p < 0.001), and a trend close to significance was expected in visceral metastasis (28.8% versus 22.1%; OR 1.29, 95% CI 0.96-1.74, p = 0.09). Incidences of pain in AR-V7-positive CRPC (54.6%) were significantly higher than in negative CRPC (28.1%; OR 4.23, 95% CI 2.52-7.10, p < 0.001), line with worse ECOG performance status (56.7% versus 35.0%, OR 2.18, 95% CI 1.51-3.16, P < 0.001). Limitations of the study include differences in sample sizes and designs, AR-V7 detection assays, as well as disease characteristics of the included studies.
CONCLUSIONS: AR-V7 positivity is associated with a higher Gleason score, bone or any site metastasis, pain and worse ECOG performance scores in CRPC. However, it is not correlated with tumor stage or lymph node metastasis. More studies are needed to confirm these findings.