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Epigenetic risk score improves prostate cancer risk assessment

(2017) PROSTATE. 77(12). p.1259-1264
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Abstract
Background: Early detection of aggressive prostate cancer (PCa) remains crucial for effective treatment of patients. However, PCa screening remains controversial due to a high rate of overdiagnosis and overtreatment. To better reconcile both objectives, more effective methods for assessing disease severity at the time of diagnosis are needed. Methods: The relationship between DNA-methylation and high-grade PCa was examined in a cohort of 102 prospectively enrolled men who received standard 12-core prostate biopsies. EpiScore, an algorithm that quantifies the relative DNA methylation intensities of GSTP1, RASSF1, and APC in prostate biopsy tissue, was evaluated as a method to compensate for biopsy under-sampling and improve risk stratification at the time of diagnosis. Results: DNA-methylation intensities of GSTP1, RASSF1, and APC were higher in biopsy cores from men diagnosed with GS7 cancer compared to men with diagnosed GS 6 disease. This was confirmed by EpiScore, which was significantly higher for subjects with high-grade biopsies and higher NCCN risk categories (both P<0.001). In patients diagnosed with GS7, increased levels of DNA-methylation were present, not only in the high-grade biopsy cores, but also in other cores with no or low-grade disease (P<0.001). By combining EpiScore with traditional clinical risk factors into a logistic regression model, the prediction of high GS reached an AUC of 0.82 (95%CI: 0.73-0.91) with EpiScore, DRE, and atypical histological findings as most important contributors. Conclusions: In men diagnosed with PCa, DNA-methylation profiling can detect under-sampled high-risk PCa in prostate biopsy specimens through a field effect. Predictive accuracy increased when EpiScore was combined with other clinical risk factors. These results suggest that EpiScore could aid in the detection of occult high-grade disease at the time of diagnosis, thereby improving the selection of candidates for Active Surveillance.
Keywords
epigenetic, Gleason grade, logistic regression model, prognosis, prostate cancer, risk score, HISTOPATHOLOGICALLY NEGATIVE BIOPSIES, PROMOTER METHYLATION, ACTIVE SURVEILLANCE, GSTP1, STRATIFICATION, MORTALITY, GRADE, APC

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Citation

Please use this url to cite or link to this publication:

MLA
Van Neste, Leander et al. “Epigenetic Risk Score Improves Prostate Cancer Risk Assessment.” PROSTATE 77.12 (2017): 1259–1264. Print.
APA
Van Neste, L., Groskopf, J., Grizzle, W. E., Adams, G. W., DeGuenther, M. S., Kolettis, P. N., Bryant, J. E., et al. (2017). Epigenetic risk score improves prostate cancer risk assessment. PROSTATE, 77(12), 1259–1264.
Chicago author-date
Van Neste, Leander, Jack Groskopf, William E Grizzle, George W Adams, Mark S DeGuenther, Peter N Kolettis, James E Bryant, et al. 2017. “Epigenetic Risk Score Improves Prostate Cancer Risk Assessment.” Prostate 77 (12): 1259–1264.
Chicago author-date (all authors)
Van Neste, Leander, Jack Groskopf, William E Grizzle, George W Adams, Mark S DeGuenther, Peter N Kolettis, James E Bryant, Gary P Kearney, Michael C Kearney, Wim Van Criekinge, and Sandra M Gaston. 2017. “Epigenetic Risk Score Improves Prostate Cancer Risk Assessment.” Prostate 77 (12): 1259–1264.
Vancouver
1.
Van Neste L, Groskopf J, Grizzle WE, Adams GW, DeGuenther MS, Kolettis PN, et al. Epigenetic risk score improves prostate cancer risk assessment. PROSTATE. 2017;77(12):1259–64.
IEEE
[1]
L. Van Neste et al., “Epigenetic risk score improves prostate cancer risk assessment,” PROSTATE, vol. 77, no. 12, pp. 1259–1264, 2017.
@article{8553444,
  abstract     = {Background: Early detection of aggressive prostate cancer (PCa) remains crucial for effective treatment of patients. However, PCa screening remains controversial due to a high rate of overdiagnosis and overtreatment. To better reconcile both objectives, more effective methods for assessing disease severity at the time of diagnosis are needed. 
Methods: The relationship between DNA-methylation and high-grade PCa was examined in a cohort of 102 prospectively enrolled men who received standard 12-core prostate biopsies. EpiScore, an algorithm that quantifies the relative DNA methylation intensities of GSTP1, RASSF1, and APC in prostate biopsy tissue, was evaluated as a method to compensate for biopsy under-sampling and improve risk stratification at the time of diagnosis. 
Results: DNA-methylation intensities of GSTP1, RASSF1, and APC were higher in biopsy cores from men diagnosed with GS7 cancer compared to men with diagnosed GS 6 disease. This was confirmed by EpiScore, which was significantly higher for subjects with high-grade biopsies and higher NCCN risk categories (both P<0.001). In patients diagnosed with GS7, increased levels of DNA-methylation were present, not only in the high-grade biopsy cores, but also in other cores with no or low-grade disease (P<0.001). By combining EpiScore with traditional clinical risk factors into a logistic regression model, the prediction of high GS reached an AUC of 0.82 (95%CI: 0.73-0.91) with EpiScore, DRE, and atypical histological findings as most important contributors. 
Conclusions: In men diagnosed with PCa, DNA-methylation profiling can detect under-sampled high-risk PCa in prostate biopsy specimens through a field effect. Predictive accuracy increased when EpiScore was combined with other clinical risk factors. These results suggest that EpiScore could aid in the detection of occult high-grade disease at the time of diagnosis, thereby improving the selection of candidates for Active Surveillance.},
  author       = {Van Neste, Leander and Groskopf, Jack and Grizzle, William E and Adams, George W and DeGuenther, Mark S and Kolettis, Peter N and Bryant, James E and Kearney, Gary P and Kearney, Michael C and Van Criekinge, Wim and Gaston, Sandra M},
  issn         = {0270-4137},
  journal      = {PROSTATE},
  keywords     = {epigenetic,Gleason grade,logistic regression model,prognosis,prostate cancer,risk score,HISTOPATHOLOGICALLY NEGATIVE BIOPSIES,PROMOTER METHYLATION,ACTIVE SURVEILLANCE,GSTP1,STRATIFICATION,MORTALITY,GRADE,APC},
  language     = {eng},
  number       = {12},
  pages        = {1259--1264},
  title        = {Epigenetic risk score improves prostate cancer risk assessment},
  url          = {http://dx.doi.org/10.1002/pros.23385},
  volume       = {77},
  year         = {2017},
}

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