title: Combined analysis of CRMP4 methylation levels and CAPRA-S score predicts metastasis and outcomes in prostate cancer patients.
abstract: The present study analyzed the predictive value of combined analysis of collapsin response mediator protein 4 (CRMP4) methylation levels and the Cancer of the Prostate Risk Assessment (CAPRA-S) Postsurgical score of patients who required adjuvant hormone therapy (AHT) after radical prostatectomy (RP). We retrospectively analyzed 305 patients with prostate cancer (PCa) who received RP and subsequent androgen deprivation therapy (ADT). Two hundred and thirty patients with clinically high-risk PCa underwent immediate ADT, and 75 patients with intermediate risk PCa underwent deferred ADT. CRMP4 methylation levels in biopsies were determined, and CAPRA-S scores were calculated. In the deferred ADT group, the values of the hazard ratios for tumor progression and cancer-specific mortality (CSM) in patients with ≥15% CRMP4 methylation were 6.81 (95% CI: 2.34-19.80) and 12.83 (95% CI: 2.16-26.10), respectively. Receiver-operating characteristic curve analysis indicated that CRMP4 methylation levels ≥15% served as a significant prognostic marker of tumor progression and CSM. In the immediate ADT group, CAPRA-S scores ≥6 and CRMP4 methylation levels ≥15% were independent predictors of these outcomes (uni- and multi-variable Cox regression analyses). The differences in the 5-year progression-free survival between each combination were statistically significant. Combining CAPRA-S score and CRMP4 methylation levels improved the area under the curve compared with the CRMP4 or CAPRA-S model. Therefore, CRMP4 methylation levels ≥15% were significantly associated with a poor prognosis and their combination with CAPRA-S score accurately predicted tumor progression and metastasis for patients requiring AHT after RP.
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Qun-Xiong
authors.initials: QX
authors.lastname: Huang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Chu-Tian
authors.initials: CT
authors.lastname: Xiao
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Min-Hua
authors.initials: MH
authors.lastname: Lu
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Pang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Di
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Zi-Huan
authors.initials: ZH
authors.lastname: Luo
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Sun-Yat sen University, Guangzhou 510630, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008745:Methylation; D008875:Middle Aged; D009124:Muscle Proteins / Q000378:metabolism*; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D000077982:Progression-Free Survival; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; C102926:DPYSL3 protein, human; D009124:Muscle Proteins