So Alan, Gleave Martin, Hurtado-Col Antonio, Nelson Colleen
The Prostate Centre, Vancouver General Hospital, University of British Columbia, 2660 Oak Street, BC V6H 3Z6, Vancouver, Canada.
World J Urol. 2005 Feb;23(1):1-9. doi: 10.1007/s00345-004-0473-1. Epub 2005 Jan 27.
The effectiveness of androgen ablation in the management of advanced prostate cancer is of limited duration, with the median length of response being only 18-24 months. The transition of the prostate cancer cell to an androgen independent phenotype is a complex process that involves selection and outgrowth of pre-existing clones of androgen-independent cells (clonal selection) as well as adaptive up-regulation of genes that help the cancer cells survive and grow after androgen ablation (adaptation). These two mechanisms share an important pre-requisite characteristic: prostate cancers are heterogeneous tumours comprised of various subpopulations of cells that respond differently to androgen withdrawal therapy. This tumour heterogeneity may reflect either a multifocal origin, adaptation to environmental stimuli, and/or genetic instability of the initial cancer. This review will reexamine the different mechanisms that enable prostate cancer cells to proliferate in an androgen depleted environment.
雄激素剥夺疗法在晚期前列腺癌治疗中的有效性持续时间有限，中位缓解期仅为18 - 24个月。前列腺癌细胞向雄激素非依赖表型的转变是一个复杂的过程，涉及雄激素非依赖细胞的预先存在克隆的选择和增殖（克隆选择）以及在雄激素剥夺后帮助癌细胞存活和生长的基因的适应性上调（适应）。这两种机制有一个重要的先决条件特征：前列腺癌是异质性肿瘤，由对雄激素撤退疗法反应不同的各种细胞亚群组成。这种肿瘤异质性可能反映了多灶性起源、对环境刺激的适应和/或初始癌症的基因不稳定性。本综述将重新审视使前列腺癌细胞在雄激素缺乏环境中增殖的不同机制。
