评估 17 基因基因组前列腺评分®（GPS；MDxHealth，尔湾，加利福尼亚州，美国）对根治性前列腺切除术 (RP) 阳性边缘前列腺癌的效用，了解其与随后生化复发风险 (BCR) 的关系）。我们为 BCR 的结果设计了一个病例队列，从 2008 年至 2017 年在约翰·霍普金斯大学接受治疗的 813 名 RP 患者中选择了 223 名患者，这些患者具有阳性切缘和可用的临床数据；其中，213 人拥有可用的组织和临床数据。从邻近阳性手术切缘的福尔马林固定石蜡包埋的肿瘤组织中分离出 RNA，其中 203 名患者的 GPS 可以进行评估，评分范围为 0 到 100，评分越高表明风险越高。所有患者都接受了 RP，有或没有辅助放射治疗 (ART)。统计分析采用 Cox 比例风险回归模型来计算病例队列设计的 BCR 加权结果。在单变量分析中，GPS 每增加 20 个单位，BCR 风险就会增加近三倍（风险比 [HR]/ 20 单位2.82，P < 0.001）。在根据年龄、种族、前列腺癌风险评估术后评分、阳性边缘分级组和 ART 进行调整的多变量 Cox 模型中，GPS 与 BCR 显着相关（HR 1.56 每 20  单位；95% 置信区间 1.11- 2.19；P = 0.011)。该研究因其回顾性和单一机构设计而受到限制。阳性手术切缘处的 GPS 有助于对预后进行分层，并为 RP 后辅助治疗的临床决策提供信息。© 2024 BJU International。

To evaluate the utility of the 17-gene Genomic Prostate Score® (GPS; MDxHealth, Irvine, CA, USA) performed on prostate cancer at the positive margin of the radical prostatectomy (RP) for its association with risk of subsequent biochemical recurrence (BCR).We designed a case-cohort for the outcome of BCR, selecting 223 from a cohort of 813 RP patients treated at Johns Hopkins from 2008 to 2017 with positive margins and available clinical data; of these, 213 had available tissue and clinical data. RNA was isolated from formalin-fixed paraffin-embedded tumour tissue adjacent to the positive surgical margin and the GPS was evaluable in 203 of these patients with a score ranging from 0 to 100, with higher scores indicating higher risk. All patients underwent RP with or without adjuvant radiation therapy (ART). The statistical analysis employed Cox proportional hazards regression models for outcome of BCR weighted for case-cohort design.In univariable analysis, every 20-unit increase in the GPS was associated with a nearly threefold increase in risk of BCR (hazard ratio [HR] per 20 units 2.82, P < 0.001). In a multivariable Cox model adjusted for age, race, Cancer of the Prostate Risk Assessment Postsurgical score, Grade Group at the positive margin, and ART, the GPS was significantly associated with BCR (HR 1.56 per 20 units; 95% confidence interval 1.11-2.19; P = 0.011). The study is limited by its retrospective and single institution design.The GPS at the positive surgical margin could help stratify prognosis and inform clinical decision-making regarding adjuvant therapy after RP.© 2024 BJU International.