Han Ken-Ryu, Seligson David B, Liu Xueli, Horvath Steve, Shintaku Peter I, Thomas George V, Said Jonathan W, Reiter Robert E
Department of Urology, University of California-Los Angeles David Geffen School of Medicine, Los Angeles, California 90095-1738, USA.
J Urol. 2004 Mar;171(3):1117-21. doi: 10.1097/01.ju.0000109982.60619.93.
Few successful therapeutic options exist for men who present with metastatic prostate cancer (CaP) or for the 30% with recurrence. The development and characterization of molecular markers are vital to the development of prognostic and therapeutic modalities in CaP. We investigated the expression and potential clinical usefulness of prostate stem cell antigen (PSCA) in CaP using tissue microarrays.
Immunohistochemical analysis using a PSCA monoclonal antibody was performed on tissue microarrays constructed from paraffin embedded specimens from 246 patients who underwent radical retropubic prostatectomy. PSCA staining was correlated with established prognostic factors, such as Gleason score, prostate specific antigen (PSA), and seminal vesicle invasion. In addition, recurrence-free survival was analyzed.
A high PSCA intensity of 3 was associated with adverse prognostic features, such as Gleason score 7 and above (p = 0.001), seminal vesicle invasion (p = 0.005) and capsular involvement (p = 0.033). On univariate analysis tumors with a PSCA intensity of 3 carried an increased risk of PSA recurrence (p = 0.031, HR 1.77, 95% CI 1.05 to 2.96). However, after adjusting for these variables a PSCA intensity of 3 was no longer an independent predictor of PSA recurrence.
We found that high PSCA intensity is significantly associated with adverse prognostic features such as high Gleason score and extra-organ disease. The results of this study suggest that PSCA is a promising tumor marker for the selection of patients at high risk but additional studies are necessary to assess the usefulness of PSCA in patient biopsies.
对于患有转移性前列腺癌（CaP）的男性或30%复发的患者，几乎没有成功的治疗选择。分子标志物的开发和特性鉴定对于CaP预后和治疗方式的发展至关重要。我们使用组织微阵列研究了前列腺干细胞抗原（PSCA）在CaP中的表达及其潜在的临床应用价值。
使用PSCA单克隆抗体对由246例行耻骨后根治性前列腺切除术患者的石蜡包埋标本构建的组织微阵列进行免疫组织化学分析。PSCA染色与既定的预后因素相关，如Gleason评分、前列腺特异性抗原（PSA）和精囊侵犯。此外，还分析了无复发生存率。
PSCA高强度（强度为3）与不良预后特征相关，如Gleason评分7分及以上（p = 0.001）、精囊侵犯（p = 0.005）和包膜受累（p = 0.033）。单因素分析显示，PSCA强度为3的肿瘤发生PSA复发的风险增加（p = 0.031，HR 1.77，95%CI 1.05至2.96）。然而，在对这些变量进行调整后，PSCA强度为3不再是PSA复发的独立预测因素。
我们发现高PSCA强度与高Gleason评分和器官外疾病等不良预后特征显著相关。本研究结果表明，PSCA是一种有前景的肿瘤标志物，可用于选择高危患者，但需要进一步研究以评估PSCA在患者活检中的应用价值。
