CD44标准型、变异体3和6以及β-连环蛋白表达在接受根治性前列腺切除术的局限性前列腺癌中的预后价值

Prognostic value of CD44 standard, variant isoforms 3 and 6 and -catenin expression in local prostate cancer treated by radical prostatectomy.

作者信息

Aaltomaa S, Lipponen P, Viitanen J, Kankkunen J P, Ala-Opas M, Kosma V M

机构信息

Department of Urology, Kuopio University Hospital, Kuopio, Finland.

出版信息

Eur Urol. 2000 Nov;38(5):555-62. doi: 10.1159/000020355.

DOI:10.1159/000020355

PMID:11096236

Abstract

OBJECTIVE

The clinical and histological data of prostate cancer patients were compared with the expression of CD44 standard (CD44s), variant isoforms CD44v3, CD44v6 and alpha-catenin. The prognostic value of these adhesion molecules was also analysed.

PATIENTS AND METHODS

We analysed the clinical and histological data of 87 prostate cancer patients treated by radical prostatectomy in two Finnish hospitals. The mean (SD) age of the patients at diagnosis was 64 years (6) and the mean follow-up was 3 years (8). Immunohistochemistry was used to detect the expression of CD44s and its v3 (CD44v3) and v6 (CD44v6) isoforms and alpha-catenin.

RESULTS

The mean (SD) fractions of positively stained cancer cells were 38 (38), 10 (22), 56 (41) and 93% (17) for CD44s, CD44v3, CD44v6 and alpha-catenin, respectively. Low fractions of CD44s- and CD44v6-positive cancer cells were related to high preoperative prostate-specific antigen (PSA) levels (p<0.05 for both). Low fraction of CD44s positive cancer cells was linked with presence of seminal vesicle invasion (p = 0.07), surgical margin positivity (p = 0.09), high Gleason score (p = 0.04) and high mitotic index (p = 0. 02). Low fraction of CD44v3-positive cancer cells was related to positive surgical margins (p = 0.05), high Gleason score (p = 0.04), presence of perineural infiltration (p = 0.02) and absence of tumour-infiltrating lymphocytes (p = 0.02). Low fraction of CD44v6-positive cancer cells was related to high pT classification (p = 0.07), capsule invasion (p = 0.03), positive surgical margins (p = 0.05), high Gleason score (p = 0.008), perineural infiltration (p = 0.0001) and high mitotic index (p = 0.001). alpha-Catenin expression was not related to any of the clinicopathological variables included in this study. Gleason score (p = 0.001), pT classification (p = 0.007), perineural infiltration (p = 0.01) and the fraction of CD44v3-positive cancer cells (p = 0.04) were predictors of PSA failure in univariate analysis. pT category (p = 0. 012), Gleason score (p = 0.02) and expression of CD44v3 (p = 0.0003) were independent predictors of PSA failure.

CONCLUSIONS

The expression of CD44s, CD44v3 and CD44v6 is related to tumour differentiation. The expression of CD44v3 independently predicts PSA failure in addition to Gleason score and pT category during a short-term follow-up.

摘要

目的

比较前列腺癌患者的临床和组织学数据与CD44标准型（CD44s）、变异体CD44v3、CD44v6及α-连环蛋白的表达情况。并分析这些黏附分子的预后价值。

患者与方法

我们分析了芬兰两家医院87例接受根治性前列腺切除术的前列腺癌患者的临床和组织学数据。患者诊断时的平均（标准差）年龄为64岁（6岁），平均随访时间为3年（8年）。采用免疫组织化学法检测CD44s及其v3（CD44v3）、v6（CD44v6）变异体以及α-连环蛋白的表达。

结果

CD44s、CD44v3、CD44v6及α-连环蛋白阳性染色癌细胞的平均（标准差）比例分别为38%（38%）、10%（22%）、56%（41%）和93%（17%）。CD44s和CD44v6阳性癌细胞比例低与术前前列腺特异性抗原（PSA）水平高相关（两者均p<0.05）。CD44s阳性癌细胞比例低与精囊侵犯（p = 0.07）、手术切缘阳性（p = 0.09）、高Gleason评分（p = 0.04）及高有丝分裂指数（p = 0.02）有关。CD44v3阳性癌细胞比例低与手术切缘阳性（p = 0.05）、高Gleason评分（p = 0.04）、神经周围浸润（p = 0.02）及无肿瘤浸润淋巴细胞（p = 0.02）有关。CD44v6阳性癌细胞比例低与高pT分期（p = 0.07）、包膜侵犯（p = 0.03）、手术切缘阳性（p = 0.05）、高Gleason评分（p = 0.008）、神经周围浸润（p = 0.0001）及高有丝分裂指数（p = 0.001）有关。α-连环蛋白表达与本研究纳入的任何临床病理变量均无关。在单因素分析中，Gleason评分（p = 0.001）、pT分期（p = 0.007）、神经周围浸润（p = 0.01）及CD44v3阳性癌细胞比例（p = 0.04）是PSA失败的预测因素。pT类别（p = 0.012）、Gleason评分（p = 0.02）及CD44v3表达（p = 0.0003）是PSA失败的独立预测因素。