Ricciardelli C, Quinn D I, Raymond W A, McCaul K, Sutherland P D, Stricker P D, Grygiel J J, Sutherland R L, Marshall V R, Tilley W D, Horsfall D J
Oncology Unit, Flinders Cancer Centre, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia.
Cancer Res. 1999 May 15;59(10):2324-8.
The disease course of localized prostate cancer is highly variable, and patients potentially curable by aggressive management are not readily identified by current clinical practice. Chondroitin sulfate (CS) glycosaminoglycan is a candidate biomarker as elevated levels of CS in peritumoral stroma of prostate cancer have been associated with prostate-specific antigen (PSA) failure. Immunoreactive CS was measured using image analysis of archived radical prostatectomy tissues, obtained from 157 men with a median of 47 months (range, 16-111 months) clinical follow-up. CS level, Gleason score, and preoperative serum PSA levels were independent predictors of PSA failure by Cox's multivariate analysis. Patients with low CS levels had significantly fewer PSA failures after radical prostatectomy than patients with high levels of CS (Kaplan-Meier plot; 32% PSA failures at 5 years for CS mean integrated absorbance cut point < 7.0 versus 50% for CS > or = 7.0, P = 0.0001). In the subgroup of patients with preoperative serum PSA levels < 10 ng/ml, CS was particularly useful in discriminating retrospectively those patients most suited for surgery (Kaplan-Meier plot; 14% PSA failures at 5 years for CS mean integrated absorbance cut point < 7.0 versus 47% for CS > or = 7.0, P = 0.0001). We conclude that measurements of CS level can assist in predicting patient outcome after surgery. Additionally, our data suggest that the combination of CS and PSA measurements may improve outcome prediction for patients with intermediate Gleason scores.
局限性前列腺癌的病程变化很大，目前的临床实践难以轻易识别出可通过积极治疗治愈的患者。硫酸软骨素（CS）糖胺聚糖是一种候选生物标志物，因为前列腺癌肿瘤周围基质中CS水平升高与前列腺特异性抗原（PSA）失败有关。使用图像分析对157名男性的存档根治性前列腺切除术组织进行免疫反应性CS测量，这些男性的临床随访时间中位数为47个月（范围为16 - 111个月）。通过Cox多变量分析，CS水平、Gleason评分和术前血清PSA水平是PSA失败的独立预测因素。根治性前列腺切除术后，CS水平低的患者PSA失败的情况明显少于CS水平高的患者（Kaplan - Meier曲线；CS平均积分吸光度切点<7.0时，5年时PSA失败率为32%，而CS≥7.0时为50%，P = 0.0001）。在术前血清PSA水平<10 ng/ml的患者亚组中，CS在回顾性区分最适合手术的患者方面特别有用（Kaplan - Meier曲线；CS平均积分吸光度切点<7.0时，5年时PSA失败率为14%，而CS≥7.0时为47%，P = 0.0001）。我们得出结论，CS水平的测量有助于预测手术后的患者预后。此外，我们的数据表明，CS和PSA测量相结合可能会改善中Gleason评分患者的预后预测。
