Department of Urology, The First Affiliated Hospital of Guangzhou Medical College, Guangdong Province, China.
Int J Cancer. 2012 Aug 15;131(4):902-10. doi: 10.1002/ijc.26459. Epub 2011 Nov 9.
Recent studies show that prostate stem cell antigen (PSCA) mRNA positivity in peripheral blood correlates with disease progression in prostate cancer (PCa). Our study is to evaluate the association between peripheral blood PSCA status and androgen-independent progression (AIP) in a cohort of patients with advanced PCa under androgen deprivation therapy (ADT). PSCA mRNA was measured by reverse transcriptase polymerase chain reaction (RT-PCR) assay in peripheral blood samples from 116 patients with locally advanced or metastatic PCa who were treated with primary ADT and from 40 healthy controls. The Kaplan-Meier and the Cox proportional hazards methods were used to assess potential predictors of AIP. Pretreatment RT-PCR-PSCA was positive in 37 (31.9%) of 116 patients. All healthy volunteers were negative for PSCA mRNA. Although seven (14.9%) of 47 patients with Gleason score ≤7 were PSCA positive, 30 (43.5%) of 69 patients with Gleason score >7 were PSCA positive (p = 0.016). PSCA mRNA was detected in 28 (58.3%) of 48 patients with metastatic PCa, compared to nine (13.2%) of 68 patients with locally advanced disease (p = 0.012). AIP developed in 59 (50.9%) patients during a median follow-up period of 35.4 months (range: 4-78 months). Patients with PSCA negativity experienced significantly longer remissions compared to those with PSCA positivity (log-rank test: p < 0.001). Multivariate Cox regression analysis further demonstrated that PSCA positivity had a significantly increased risk of AIP (HR = 4.303, 95% CI: 3.761-7.482, p < 0.001). Pretreatment RT-PCR PSCA positivity in peripheral blood independently signals the presence of AIP in patients with advanced PCa treated with ADT.
最近的研究表明，外周血前列腺干细胞抗原（PSCA）mRNA 阳性与前列腺癌（PCa）的疾病进展相关。我们的研究旨在评估雄激素剥夺治疗（ADT）下晚期 PCa 患者外周血 PSCA 状态与雄激素非依赖性进展（AIP）之间的关系。通过逆转录聚合酶链反应（RT-PCR）检测 116 例局部晚期或转移性 PCa 患者（接受初始 ADT）和 40 例健康对照者外周血样本中的 PSCA mRNA。采用 Kaplan-Meier 和 Cox 比例风险方法评估 AIP 的潜在预测因子。116 例患者中，37 例（31.9%）预处理 RT-PCR-PSCA 阳性。所有健康志愿者 PSCA mRNA 均为阴性。虽然 Gleason 评分≤7 的 47 例患者中有 7 例（14.9%）为 PSCA 阳性，但 Gleason 评分>7 的 69 例患者中有 30 例（43.5%）为 PSCA 阳性（p=0.016）。转移性 PCa 患者中 48 例（58.3%）检测到 PSCA mRNA，而局部晚期疾病患者中 68 例（13.2%）检测到 PSCA mRNA（p=0.012）。在中位随访 35.4 个月（范围：4-78 个月）期间，59 例（50.9%）患者发生 AIP。PSCA 阴性患者的缓解时间明显长于 PSCA 阳性患者（对数秩检验：p<0.001）。多变量 Cox 回归分析进一步表明，PSCA 阳性患者 AIP 的风险显著增加（HR=4.303，95%CI：3.761-7.482，p<0.001）。ADT 治疗的晚期 PCa 患者外周血预处理 RT-PCR PSCA 阳性独立提示存在 AIP。
