Antunes Alberto A, Leite Kátia R, Sousa-Canavez Juliana M, Camara-Lopes Luiz H, Srougi Miguel
Division of Urology, Laboratory of Medicine Investigation, University of Sao Paulo Medical School, São Paulo, Brazil.
J Urol. 2009 Feb;181(2):594-600. doi: 10.1016/j.juro.2008.10.007. Epub 2008 Dec 13.
The diagnosis of prostate cancer in men with persistently increased prostate specific antigen after a negative prostate biopsy has become a great challenge for urologists and pathologists. We analyzed the diagnostic value of 6 genes in the tissue of patients with prostate cancer.
The study was comprised of 50 patients with localized disease who underwent radical prostatectomy. Gene selection was based on a previous microarray analysis. Among 4,147 genes with different expressions between 2 pools of patients 6 genes (PSMA, TMEFF2, GREB1, TH1L, IgH3 and PGC) were selected. These genes were tested for diagnostic value using the quantitative reverse transcription polymerase chain reaction method. Initially malignant tissue samples from 33 patients were analyzed and in the second part of the study we analyzed benign tissue samples from the other 17 patients with prostate cancer. The control group was comprised of tissue samples of patients with benign prostatic hyperplasia.
Analysis of malignant prostatic tissue demonstrated that prostate specific membrane antigen was over expressed (mean 9 times) and pepsinogen C was under expressed (mean 1.3 x 10(-4) times) in all cases compared to benign prostatic hyperplasia. The other 4 tested genes showed a variable expression pattern not allowing for differentiation between benign and malignant cases. When we tested these results in the benign prostate tissues from patients with cancer, pepsinogen C maintained the expression pattern. In terms of prostate specific membrane antigen, despite over expression in most cases (mean 12 times), 2 cases (12%) presented with under expression.
Pepsinogen C tissue expression may constitute a powerful adjunctive method to prostate biopsy in the diagnosis of prostate cancer cases.
对于前列腺活检呈阴性但前列腺特异性抗原持续升高的男性患者，前列腺癌的诊断对泌尿外科医生和病理学家而言已成为一项巨大挑战。我们分析了6个基因在前列腺癌患者组织中的诊断价值。
本研究纳入了50例接受根治性前列腺切除术的局限性疾病患者。基因选择基于先前的微阵列分析。在两组患者之间表达不同的4147个基因中，选择了6个基因（前列腺特异性膜抗原、跨膜EGF样域蛋白2、生长调节致癌基因1、睾丸特异性基因1样蛋白、免疫球蛋白重链3和磷酸甘油酸酯激酶）。使用定量逆转录聚合酶链反应方法检测这些基因的诊断价值。最初分析了33例患者的恶性组织样本，在研究的第二部分，我们分析了另外17例前列腺癌患者的良性组织样本。对照组由良性前列腺增生患者的组织样本组成。
对恶性前列腺组织的分析表明，与良性前列腺增生相比，在所有病例中前列腺特异性膜抗原均过度表达（平均9倍），而胃蛋白酶原C表达不足（平均1.3×10⁻⁴倍）。其他4个检测基因显示出可变的表达模式，无法区分良性和恶性病例。当我们在癌症患者的良性前列腺组织中检测这些结果时，胃蛋白酶原C保持了表达模式。就前列腺特异性膜抗原而言，尽管在大多数情况下过度表达（平均12倍），但有2例（12%）表现为表达不足。
胃蛋白酶原C组织表达可能成为前列腺活检诊断前列腺癌病例的有力辅助方法。
