用于转移性去势抵抗性前列腺癌 (mCRPC) 基因组分析的组织来源通常仅限于骨转移。为了指导患者管理，转移部位的选择和靶向骨活检技术对于识别有害基因突变至关重要。我们的目标是确定与成功的大型 DNA 测序相关的关键参数。我们分析了 243 名患有进展性 mCRPC 的男性的参数，这些男性在 2014 年至 2018 年间接受了 269 次骨活检以进行基因组分析。对临床、影像（骨）进行了单变量和多变量分析。扫描；氟脱氧葡萄糖 [FDG] 正电子发射断层扫描 [PET]；计算机断层扫描 [CT]；以及与成功的基因组分析相关的技术（活检部位、样本数量、针规）特征。总共 269 例活检中的 159 例(59%) 生成了足够的肿瘤材料用于基因组图谱。 70 例 (26%) 失败者的组织病理学结果为 mCRPC 阴性，40 例 (15%) 的肿瘤不足以进行基因组分析。在提交进行分子测试的 199 个 mCRPC 样本中，159 个 (80%) 产生了基因组图谱。在单变量分析中，PSA、血清酸性磷酸酶、活检样本数量、FDG PET 阳性、CT 衰减和 CT 形态与基因组分析成功显着相关。在多变量分析中，FDG 最大标准化摄取值较高（优势比 [OR] 7.51，95% 置信区间 [CI] 3.01-18.78；p < 0.001），活检样本数量较多（OR 4.73，95% CI 1.49-15.02；p < 0.001）。 p = 0.008）和较低的平均 CT 衰减（OR 0.4，95% CI 0.18-0.89；p = 0.025）与测序成功显着相关。在 mCRPC 患者中，来自代谢活动部位的骨活检和较低的 CT 衰减相关通过大型 DNA 测序平台进行基因组分析的成功率更高。我们确定了与转移性前列腺癌患者骨组织成功基因检测相关的因素。我们的研究结果可能有助于指导正确的扫描技术和活检部位以制定个性化治疗计划。由 Elsevier B.V. 出版

The source of tissue for genomic profiling of metastatic castration-resistant prostate cancer (mCRPC) is often limited to osseous metastases. To guide patient management, metastatic site selection and the technique for targeted bone biopsies are critical for identifying deleterious gene mutations. Our objective was to identify key parameters associated with successful large-panel DNA sequencing.We analyzed parameters for 243 men with progressing mCRPC who underwent 269 bone biopsies for genomic profiling between 2014 and 2018. Univariate and multivariate analyses were performed for clinical, imaging (bone scan; fluorodeoxyglucose [FDG] positron emission tomography [PET]; computed tomography [CT]; magnetic resonance imaging), and technical (biopsy site, number of samples, needle gauge) features associated with successful genomic profiling.Overall, 159 of 269 biopsies (59%) generated sufficient tumor material for a genomic profile. Seventy (26%) of the failures were histopathologically negative for mCRPC and 40 (15%) had insufficient tumor for genomic profiling. Of 199 mCRPC samples submitted for molecular testing, 159 (80%) yielded a genomic profile. On univariate analysis, PSA, serum acid phosphatase, number of biopsy samples, FDG PET positivity, CT attenuation, and CT morphology were significantly associated with genomic profiling success. On multivariate analysis, higher FDG maximum standardized uptake value (odds ratio [OR] 7.51, 95% confidence interval [CI] 3.01-18.78; p < 0.001), higher number of biopsy samples (OR 4.73, 95% CI 1.49-15.02; p = 0.008), and lower mean CT attenuation (OR 0.4, 95% CI 0.18-0.89; p = 0.025) were significantly associated with sequencing success.In patients with mCRPC, bone biopsies from sites with metabolic activity and lower CT attenuation are associated with higher success rates for genomic profiling via a large-panel DNA sequencing platform.We identified factors associated with successful genetic testing of bone tissue for patients with metastatic prostate cancer. Our findings may help in guiding the right scan technique and biopsy site for personalized treatment planning.Published by Elsevier B.V.