Histologically benign PI-RADS 4 and 5 lesions contain cancer-associated epigenetic alterations.
Prostate
; 82(1): 145-153, 2022 01.
Article
in En
| MEDLINE
| ID: mdl-34672371
ABSTRACT
BACKGROUND:
The detection rate of clinically significant prostate cancer has improved with the use of multiparametric magnetic resonance imaging (mpMRI). Yet, even with MRI-guided biopsy 15%-35% of high-risk lesions (Prostate Imaging-Reporting and Data System [PI-RADS] 4 and 5) are histologically benign. It is unclear if these false positives are due to diagnostic/sampling errors or pathophysiological alterations. To better understand this, we tested histologically benign PI-RAD 4 and 5 lesions for common malignant epigenetic alterations. MATERIALS ANDMETHODS:
MRI-guided in-bore biopsy samples were collected from 45 patients with PI-RADS 4 (n = 31) or 5 (n = 14) lesions. Patients had a median clinical follow-up of 3.8 years. High-risk mpMRI patients were grouped based on their histology into biopsy positive for tumor (BPT; n = 28) or biopsy negative for tumor (BNT; n = 17). From these biopsy samples, DNA methylation of well-known tumor suppressor genes (APC, GSTP1, and RARß2) was quantified.RESULTS:
Similar to previous work we observed high rates of promoter methylation at GSTP1 (92.7%), RARß2 (57.3%), and APC (37.8%) in malignant BPT samples but no methylation in benign TURP chips. Interestingly, similar to the malignant samples the BNT biopsies also had increased methylation at the promoter of GSTP1 (78.8%) and RARß2 (34.6%). However, despite these epigenetic alterations none of these BNT patients developed prostate cancer, and those who underwent repeat mpMRI (n = 8) demonstrated either radiological regression or stability.CONCLUSIONS:
Histologically benign PI-RADS 4 and 5 lesions harbor prostate cancer-associated epigenetic alterations.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostate
/
Prostatic Neoplasms
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Ultrasonography, Interventional
/
DNA Methylation
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Image-Guided Biopsy
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Multiparametric Magnetic Resonance Imaging
Type of study:
Diagnostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Prostate
Year:
2022
Document type:
Article
Affiliation country: