Osman Iman, Mikhail Maryann, Shuch Brian, Clute Megan, Cheli Carol D, Ghani Farooq, Thiel Robert P, Taneja Samir S
Department of Urology, New York University School of Medicine, New York, NY 10016, USA.
J Urol. 2005 Dec;174(6):2174-7. doi: 10.1097/01.ju.0000181205.23233.65.
We determined the association between serum levels of shed Her-2/neu protein and disease progression in men with prostate cancer.
Serum from 279 patients enrolled in a prospective serum bank and database at New York University Medical Center was analyzed using the Food and Drug Administration approved Immuno-1 Her-2/neu assay. Patients were classified by the Prostate-Specific Antigen Working Group model into 5 groups, namely group 1-no evidence of cancer in 60, group 2-clinically localized disease in 67, group 3-prostate specific antigen increasing after therapy and no clinical metastases in 77, group 4-clinical metastases and castration sensitivity in 42, and group 5-clinical metastases and castration resistance in 33. A cutoff of 14 ng/ml for normal serum Her-2/neu was established based on the 95th order statistic in group 1.
Of 279 patients 37 (13.3%) had increased serum Her-2/neu, that is 5%, 11.9%, 10.4%, 16.7% and 33.3% in groups 1 to 5, respectively. There was a significant difference between patients with (groups 4 and 5) and without (groups 2 and 3) clinical metastases (p = 0.006). In group 5 patients serum Her-2/neu was significantly higher than in group 2 patients (p <0.02). The risk of cause specific death increased significantly with each unit increase in serum Her-2/neu (p <0.001).
Increased serum Her-2/neu correlates with the presence of metastatic disease and it may indicate an increased risk of death in patients with castrate, metastatic prostate cancer. The detection of serum Her-2/neu is a minimally invasive alternative to tumor sampling for identifying potential candidates for anti-Her-2/neu treatment strategies. Further studies are needed to optimize this assay for application in the clinical setting.
我们确定了前列腺癌男性患者血清中脱落的Her-2/neu蛋白水平与疾病进展之间的关联。
使用美国食品药品监督管理局批准的Immuno-1 Her-2/neu检测方法，对纽约大学医学中心前瞻性血清库和数据库中279例患者的血清进行分析。患者根据前列腺特异性抗原工作组模型分为5组，即第1组60例无癌症证据，第2组67例临床局限性疾病，第3组77例治疗后前列腺特异性抗原升高且无临床转移，第4组42例临床转移且对去势敏感，第5组33例临床转移且对去势抵抗。根据第1组的第95顺序统计量确定正常血清Her-2/neu的临界值为14 ng/ml。
279例患者中，37例（13.3%）血清Her-2/neu升高，第1至5组分别为5%、11.9%、10.4%、16.7%和33.3%。有临床转移（第4组和第5组）与无临床转移（第2组和第3组）的患者之间存在显著差异（p = 0.006）。第5组患者的血清Her-2/neu显著高于第2组患者（p <0.02）。血清Her-2/neu每升高一个单位，特定病因死亡风险显著增加（p <0.001）。
血清Her-2/neu升高与转移性疾病的存在相关，可能表明去势、转移性前列腺癌患者死亡风险增加。检测血清Her-2/neu是一种微创的肿瘤采样替代方法，用于识别抗Her-2/neu治疗策略的潜在候选者。需要进一步研究优化该检测方法以应用于临床环境。
