Miyake Hideaki, Muramaki Mototsugu, Kurahashi Toshifumi, Yamanaka Kazuki, Hara Isao, Gleave Martin, Fujisawa Masato
Department of Urology, Hyogo Medical Center for Adults, Akashi, Japan.
Urology. 2006 Sep;68(3):609-14. doi: 10.1016/j.urology.2006.03.017. Epub 2006 Sep 18.
To determine whether the expression level of clusterin in prostate cancer could be used as a prognostic predictor in patients who have undergone radical prostatectomy (RP).
This study included 172 consecutive patients undergoing RP for clinically organ-confined prostate cancer without neoadjuvant hormonal therapy. Immunohistochemical staining was performed in RP specimens obtained from these patients to evaluate the expression level of clusterin protein. The cell proliferative activities and apoptotic features in these specimens were investigated using Ki-67 immunostaining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay, respectively.
Varying levels of clusterin expression were noted in 169 of 172 prostate cancer specimens; 32 of the 172 normal prostatic tissue specimens did not exhibit any clusterin staining. Clusterin expression in prostate cancer tissue was significantly related to the Gleason score, but not to the other parameters, including age, serum prostate-specific antigen level, pathologic stage, perineural invasion, tumor volume, and lymph node metastasis. In addition, cell proliferative activity in the prostate cancer specimens was significantly associated with clusterin expression; however, no correlation was found between the apoptotic index and clusterin expression. In this series, 34 (19.8%) of 172 patients developed biochemical recurrence. No significant difference was found in biochemical/recurrence-free survival between patients with strong clusterin expression and those with weak expression.
Despite its detection in most prostate cancer tissue, clusterin expression failed to show a significant association with prognosis in patients undergoing RP without neoadjuvant hormonal therapy. This suggests a limited role for clusterin in the progression of clinically organ-confined prostate cancer in the absence of proapoptotic stimuli.
确定在接受根治性前列腺切除术（RP）的患者中，簇集素在前列腺癌中的表达水平是否可作为预后预测指标。
本研究纳入了172例连续接受RP治疗的临床局限期前列腺癌患者，这些患者未接受新辅助激素治疗。对这些患者的RP标本进行免疫组织化学染色，以评估簇集素蛋白的表达水平。分别使用Ki-67免疫染色和末端脱氧核苷酸转移酶介导的dUTP生物素缺口末端标记法研究这些标本中的细胞增殖活性和凋亡特征。
172例前列腺癌标本中有169例呈现不同水平的簇集素表达；172例正常前列腺组织标本中有32例未显示任何簇集素染色。前列腺癌组织中的簇集素表达与Gleason评分显著相关，但与其他参数无关，包括年龄、血清前列腺特异性抗原水平、病理分期、神经周围侵犯、肿瘤体积和淋巴结转移。此外，前列腺癌标本中的细胞增殖活性与簇集素表达显著相关；然而，凋亡指数与簇集素表达之间未发现相关性。在这组病例中，172例患者中有34例（19.8%）发生生化复发。簇集素强表达患者和弱表达患者之间的生化/无复发生存率无显著差异。
尽管在大多数前列腺癌组织中都能检测到簇集素，但在未接受新辅助激素治疗的接受RP的患者中，簇集素表达与预后未显示出显著相关性。这表明在缺乏促凋亡刺激的情况下，簇集素在临床局限期前列腺癌进展中的作用有限。
