摘要
目的 探讨前列腺癌内分泌治疗前癌组织中多种蛋白标记表达与内分泌治疗后发生进展的相关性，筛选内分泌治疗后进展的预测因子。方法收集116例接受内分泌治疗的前列腺癌患者的临床病理资料，检测患者内分泌治疗前癌组织中雄激素受体（AR）、上皮型钙黏附素（E—cadherin）、嗜铬粒蛋白A（CgA）、核增殖抗原（Ki67）、凋亡抑制蛋白（Survivin）、EZH2、hepsin蛋白表达，应用Cox比例风险模型进行多因素分析。结果Ki67、EZH2、Survivin3种蛋白表达与传统临床病理学因素存在Spearman等级相关。单因素分析中发现临床分期（P〈0．001）、Gleason评分（P=0．005）、治疗前血清PSA值（P〈0．001）以及Ki67（P=0．032）、Survivin蛋白（P=0．002）表达与内分泌治疗后的进展相关，多因素分析结果显示临床分期（TxN＋／M＋）（P〈o．001）、高病理分级（Gleason评分≥8分）（P=0．038）和Survivin蛋白高表达（P=0．031）是内分泌治疗后进展的重要危险因素。其中TxN＋／M＋者67例（57．8％），Gleason评分≥8分者56例（48．3％），Survivin蛋白高表达者91例（78．4％）。结论临床分期、病理分级、Survivin蛋白表达对于预测前列腺癌内分泌治疗后进展有重要意义。
Objective To evaluate the expression of molecular markers in prostate cancer and to clarify the significance of these markers as prognostic indicators for androgen deprivation therapy. Methods A series of 116 prostate cancer patients under androgen deprivation therapy as a single treat- ment was reviewed. Expression levels of 7 proteins, including androgen receptor（AR）, E-cadherin, Chromogranin A（CgA）, Ki-67, Survivin, EZH2 and hepsin, were measured by immunohistochemical staining. Results Of the 7 molecules, Ki67,EZH2 and Survivin expression were significantly associated with several conventional prognostic factors. Univariate analysis identified clinical stage, Gleason scores,pretreatment serum PSA level, Ki-67 and Survivin expression as significant predictors for prostate-specific antigen （PSA） progression after endocrine therapy. Of these significant factors, Survivin expression, clinical stage and Gleason scores appeared to be independently related to PSA progression after endocrine therapy by multivariate analysis. Furthermore, there were significant differences in PSA progression-free survival according to positive numbers of these three independent risk factors. Conclusion Survivin could be a useful independent prognostic factor in prostate cancer with endocrine therapy, besides clinical stage and Gleason score.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2009年第12期848-851,共4页
Chinese Journal of Urology
