CAJ | 학술논문

目的观察全雄激素阻断(CAA)治疗前后前列腺干细胞抗原(PSCA)mRNA 表达水平的变化,并进一步评估 PSCA 在人前列腺癌的临床预后价值。方法对42例男性患者的前列腺活检组织或经尿道前列腺切除组织(包括去势前局限性前列腺癌组织和前列腺癌根治术前接受比卡鲁胺和醋酸戈舍瑞林去势治疗3个月后的癌组织)进行原位杂交。PSCA mRNA 的肿瘤细胞质染色结果由两位病理学专家独立评估,t 检验分析 CAA 前后 PSCA mRNA 表达水平的差异。前列腺癌根治术后进行36~40个月的随访,旨在评估 PSCA mRNA 表达水平与癌症局部复发或转移的相关性。结果原位杂交标记 PSCA mRNA 阳性的细胞由 CAA 前的67.3%(0~89%)±9.4%下降到 CAA 后33.8%(0~92%)±7.7%(P <0.001)。CAA 前95.2%(40/42)的患者 PSCA mRNA 表达阳性,而去势后阳性率降到67.5%(27/40),且随访未发现有局部复发或远处转移。PSCA mRNA 阳性表达的减少取决于原始肿瘤的 Gleason 评分,Gleason≤6：19.3%±4.7%；Gleason=7：38.8%±7.2%；Gleason≥8：73.4%±13.8%(P <0.05)。其余13例,CAA 后 PSCA mRNA 阳性表达水平增加,且随访发现3例有局限复发,4例有远处转移。结论前列腺癌 CAA 可抑制 PSCA mRNA 的表达；去势治疗后 PSCA mRNA 表达的增加可成为肿瘤复发或远处转移的一个不利预测指标。
목적관찰전웅격소조단(CAA)치료전후전렬선간세포항원(PSCA)mRNA 표체수평적변화,병진일보평고 PSCA 재인전렬선암적림상예후개치。방법대42례남성환자적전렬선활검조직혹경뇨도전렬선절제조직(포괄거세전국한성전렬선암조직화전렬선암근치술전접수비잡로알화작산과사서림거세치료3개월후적암조직)진행원위잡교。PSCA mRNA 적종류세포질염색결과유량위병이학전가독립평고,t 검험분석 CAA 전후 PSCA mRNA 표체수평적차이。전렬선암근치술후진행36~40개월적수방,지재평고 PSCA mRNA 표체수평여암증국부복발혹전이적상관성。결과원위잡교표기 PSCA mRNA 양성적세포유 CAA 전적67.3%(0~89%)±9.4%하강도 CAA 후33.8%(0~92%)±7.7%(P <0.001)。CAA 전95.2%(40/42)적환자 PSCA mRNA 표체양성,이거세후양성솔강도67.5%(27/40),차수방미발현유국부복발혹원처전이。PSCA mRNA 양성표체적감소취결우원시종류적 Gleason 평분,Gleason≤6：19.3%±4.7%；Gleason=7：38.8%±7.2%；Gleason≥8：73.4%±13.8%(P <0.05)。기여13례,CAA 후 PSCA mRNA 양성표체수평증가,차수방발현3례유국한복발,4례유원처전이。결론전렬선암 CAA 가억제 PSCA mRNA 적표체；거세치료후 PSCA mRNA 표체적증가가성위종류복발혹원처전이적일개불리예측지표。
Objective The purpose of the present study was to investigate the variations in the ex-pression levels of prostate stem cell antigen (PSCA)mRNA before and after complete androgen ablation (CAA),and further evaluate the clinically prognostic value of PSCA in human prostate carcinoma. Meth-ods PSCA in situ hybridization (ISH)was performed on the cancerous pretreatment biopsy or transure-thral resection of prostate tissue of 42 men with primarily organ-confined prostate cancer before CAA,and on their tumor tissue from radical retropubic prostatectomy after CAA with bicalutamide and goserelin ace-tate for 3 months prior to undergoing radical prostatectomy.Tumor cytoplasmic staining of PSCA mRNA was evaluated by two independent pathologists and the differences of PSCA mRNA expression levels between the samples before and after CAA were analyzed using the Student's t-test.Thirty-six to forty months follow-up studies after radical retropubic prostatectomy were performed and aimed at assessing the correlation of PSCA mRNA expression level with local recurrences or metastases from the cancer. Results The percent of cells positive for PSCA mRNA by ISH labeling declined from 67.3% (0-89%)±9.4% before CAA to 33.8% (0-92%)±7.7% after CAA (P <0.001 ).Before CAA,40 of 42 cases (95.2%)were positive for PSCA mRNA labeling,however,after CAA the percentage of positive reactivity of PSCA mRNA was decreased to 27 of 40 cases (67.5%),in which none was found with local recurrences or distant metastases after radical prostatectomy on follow-up . This decline in PSCA mRNA labeling was dependent on the original tumor grade with Gleason score of ≤6:1 9.3%±4.7%, Gleason score of 7:38.8%±7.2%,and a Gleason score of ≥8:73.4%±13.8% (P <0.05,respectively).The rest 13 cases had the increased percentage of cells positive for PSCA mRNA after CAA,in which 3 cases were found with local recurrences and 4 ca-ses with distant metastases from tumor on follow-up. Conclusions Our data demonstrate that CAA for prostate cancer can sup-press PSCA mRNA expression with a tumor grade dependence and the increased expression of PSCA mRNA after CAA may be a clinically adverse predictor for tumor recurrences or distant metastases.