AR-V7表达与去势抵抗性前列腺癌阿比特龙治疗敏感性的相关性研究

The value of AR-V7 in predicting therapeutic efficiency of abiraterone for CRPC patients

目的:探讨去势抵抗性前列腺癌(CRPC)患者中雄激素受体剪切变异体7(AR-V7)的表达与阿比特龙治疗敏感性的相关性。方法:采用前瞻性队列研究对2016年1月至2019年1月北京大学肿瘤医院收治的年龄≥18岁,存在1≥处全身转移,拟使用阿比特龙治疗的新发CRPC患者行外周血循环肿瘤细胞(CTCs)AR-V7检测,根据检测结果将患者分为AR-V7阳性组和AR-V7阴性组,对两组患者PSA下降时间、PSA无进展生存(PFS)、临床状态PFS、影像学PFS以及总生存进行统计分析。结果:共入组77例患者,其中AR-V7阴性组49例,AR-V7阳性组28例。AR-V7阴性组PSA下降时间[(72.04±66.92)d与(190.11±102.44)d,P=0.000]、PSA无应答率[6.12%(3/49)与21.4%(6/28),P=0.040]明显小于AR-V7阳性组,而PSA PFS[(489.17±269.39)d与(130.56±120)d,P=0.010]、临床状态PFS[(551.91±322.05)d与(261.44±200.85)d,P=0.018]、影像学PFS[(523.7±223.28)d与(247.56±202.80)d,P=0.003]明显长于AR-V7阳性组。AR-V7阳性组和AR-V7阴性组的肿瘤特异性生存时间分别为(1246.89±375.65)d和(1001.42±248.94)d(P=0.159),总生存率分别为89.8%(44/49)和89.3%(25/28)(P=0.176),差异均无统计学意义。结论:CRPC患者中,AR-V7表达与阿比特龙治疗敏感性及患者预后密切相关,阳性表达患者阿比特龙治疗效果及预后较差。

Objective Determine the relationship between AR-V7 expression and treatment efficiency of abiraterone.Methods A prospective cohort study was conducted to detect CTCs AR-V7 in newly diagnosed CRPC patients,aged≥18 years who were admitted to the urologic department of Peking University cancer hospital from January 2016 to January 2019,with one or more systemic metastases.All the patients intended to be treated with abiraterone.According to the AR-V7 status,patients were divided into 2 groups(AR-V7 positive and negative).PSA decline time,PSA PFS,clinical status PFS,imaging PFS and CSS are analyzed and compared by t-test and Chi-square between 2 groups.Result 49 patients were AR-V7 negative and 28 were AR-V7 positive.Compared with AR-V7 positive patients,PSA decline time(72.04±66.92 vs.190.11±102.44,P=0.000),PSA non-response rate(6.12%vs.21.4%,P=0.040)are significantly lower in AR-V7 negative patients.PSA PFS(489.17±269.39 vs.130.56±120,P=0.010),Clinical PFS(551.91±322.05 vs.261.44±200.85,P=0.018),and Imaging PFS(523.7±223.28 vs.247.56±202.80,P=0.003)are significantly longer in AR-V7 negative patients.Conclusion Expression status of AR-V7 is related to the response of abiraterone treatment and the prognosis of the patients.