雄激素受体辅调节因子在前列腺癌内分泌治疗中的预测意义

Expression of Androgen Receptor Coregulators in Prostate Cancer and Its Value in Predicting the Prognosis of Patients after Endocrine Therapy

  • 摘要: 目的:探讨前列腺癌内分泌治疗之前,癌组织中雄激素受体辅调节因子的表达与内分泌治疗后肿瘤进展的相关性,筛选内分泌治疗后进展相关的预测因子。方法:收集2000年1 月至2007年12月鼓楼医院116 例接受内分泌治疗的前列腺癌患者的临床病理资料,并用免疫组化EnVision 染色方法检测所有病例在内分泌治疗前癌组织中甾体受体辅激活子1(steroid receptor coactivator- 1,SRC-1)及视黄醛和甲状腺激素受体沉默调节子(silencing mediator for retinoid and thyroid hormone receptors,SMRT)蛋白表达,χ2检验或Fisher 精确概率检验分析临床病理因素与蛋白标记表达相关性;各临床病理因素及蛋白标记表达的单因素分析采用Log-rank 检验,多因素分析采用Cox 比例风险回归模型进行分析。结果:SRC-1 蛋白表达与传统临床病理因素存在等级相关。单因素分析中发现临床分期、Gleason评分、治疗前血清PSA 值以及SRC-1 蛋白表达与内分泌治疗后的进展相关,多因素分析表明高临床分期(TxN+/M+ )、SRC-1 蛋白高表达是内分泌治疗后进展的危险因素。结论:联合临床分期、SRC-1 蛋白表达检测将有助于对前列腺癌内分泌治疗后进展的预测。

     

    Abstract: Objective:To evaluate the expression levels of androgen receptor coregulators in prostate cancer and their significance in predicting the prognosis of patients treated with endocrine therapy. Methods:Clinical and pathological data of 116 cases of prostate cancer treated with endocrine therapy were collected between January 2000and November 2007 in our hospital. The expression of steroid receptor coactivator- 1 (SRC- 1) and silencing mediator for retinoid and thyroid hor -mone receptors (SMRT) were detected with immunohistochemical EnVision method in paraffin-embeded tissue. Relation-ship of SRC- 1 and SMRT expression with clinicopathologic characteristics was investigated through χ2 test or Fish exact test. Clinicopathologic factors and protein expression that influence the progression-free survival of prostate cancer pa -tients were analyzed with univariate (log-rank test) and multivariate Cox proportional hazard model. Results:SRC-1 expres-sion was significantly associated with several conventional prognostic factors. Univariate analysis showed that clinical stage, Gleason sum, pretreatment serum PSA level and SRC- 1 expression were significant predictors for PSA progression after endocrine therapy. Multivariate analysis revealed that SRC- 1 expression and clinical stage were independently corre -lated with PSA progression after endocrine therapy. Conclusion:SRC 1 is an independent prognostic factor for prostate can -cer patients treated with endocrine therapy. Combined evaluation of SRC- 1 expression and clinical stage would be particu -larly useful for predicting the outcome of prostate cancer patients treated with endocrine therapy.

     

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