Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan 48202-3450, USA.
Prostate. 2011 Jun 1;71(8):857-71. doi: 10.1002/pros.21302. Epub 2010 Nov 17.
Radical prostatectomy (RP) is not curative if patients have undetected metastatic prostate cancer. Markers that indicate the presence of metastatic disease would identify men who may benefit from systemic adjuvant therapy. Our approach was to analyze the primary tumors of men with metastatic disease versus organ-confined disease to identify molecular changes that distinguish between these groups.
Patients were identified based on long-term follow-up of serum prostate specific antigen (PSA) levels following RP. We compared the tumors of African American (AA) men with undetectable serum PSA for >9 year after RP (good outcome) versus those of AA men with a rising PSA and recurrence after radiation or androgen ablation or both (poor outcome). We used real-time quantitative PCR to assay gene copy number alterations in tumor DNA relative to patient-matched non-tumor DNA isolated from paraffin-embedded tissue. We assayed several genes located in the specific regions of chromosome 8p and 8q that frequently undergo loss and/or gain, respectively, in prostate cancer, and the androgen receptor gene at Xq12.
Gain of the MIR151 gene at 8q24.3 (in 33% of poor outcome vs. 6% of good outcome tumors) and/or loss of the NKX3-1 gene at 8p21.2 (in 39% of poor outcome vs. 11% of good outcome tumors) affected 67% of poor outcome tumors, compared to only 17% of good outcome tumors.
Copy number gain of the MIR151 gene and/or loss of the NKX3-1 gene in the primary tumor may indicate the presence of metastatic disease.
如果患者存在未检测到的转移性前列腺癌,根治性前列腺切除术(RP)不能治愈。提示存在转移性疾病的标志物将确定可能受益于系统辅助治疗的男性。我们的方法是分析患有转移性疾病与器官局限疾病的男性的原发性肿瘤,以确定区分这两组的分子变化。
根据 RP 后血清前列腺特异性抗原(PSA)水平的长期随访,确定患者。我们比较了 AA 男性的肿瘤,这些男性的血清 PSA 在 RP 后 >9 年仍无法检测到(预后良好),与那些 PSA 升高且在放疗或雄激素剥夺或两者均有的 AA 男性的肿瘤(预后不良)。我们使用实时定量 PCR 来检测肿瘤 DNA 相对于从石蜡包埋组织中分离的患者匹配的非肿瘤 DNA 的基因拷贝数改变。我们检测了位于染色体 8p 和 8q 上的几个基因,这些基因在前列腺癌中分别经常发生缺失和/或获得,以及 Xq12 上的雄激素受体基因。
8q24.3 上 MIR151 基因的获得(在 33%的预后不良肿瘤中,而在 6%的预后良好肿瘤中)和/或 8p21.2 上 NKX3-1 基因的缺失(在 39%的预后不良肿瘤中,而在 11%的预后良好肿瘤中)影响了 67%的预后不良肿瘤,而仅影响了 17%的预后良好肿瘤。
原发性肿瘤中 MIR151 基因的拷贝数增加和/或 NKX3-1 基因的缺失可能表明存在转移性疾病。