Fan Liancheng, Wang Yanqing, Chi Chenfei, Pan Jiahua, Xun Shangguan, Xin Zhixiang, Hu Jianian, Zhou Lixin, Dong Baijun, Xue Wei
Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
BJU Int. 2017 Aug;120(2):226-232. doi: 10.1111/bju.13781. Epub 2017 Feb 19.
To determine the prognostic utility of serum chromogranin A (CgA) and neurone-specific enolase (NSE) variations during the first 3 months of abiraterone acetate (AA) treatment in patients with metastatic castration-resistant prostate cancer (mCRPC).
The serum levels of CgA, NSE were measured at baseline and after 3 months of AA treatment in 40 patients with mCRPC. Outcome measures were prostate-specific antigen progression-free survival (PSA-PFS), radiographic PFS (rPFS), and overall survival (OS).
CgA levels were not correlated with NSE levels (P = 0.296). In multivariate analysis the combination of CgA and NSE (≥1 marker positive vs both markers negative) and the combination of CgA and NSE elevation during the first 3 months of AA treatment (≥1 marker positive vs both markers negative) remained significant predictors of OS, rPFS, and PSA-PFS.
We found that CgA and NSE elevation during the first 3 months of AA treatment and elevated baseline CgA and NSE levels were independent prognostic factors for OS, rPFS and PSA-PFS in patients with mCRPC treated with AA. This suggests that serial CgA and NSE evaluation may help clinicians in distinguishing patients with mCRPC who would obtain the best survival benefit from AA treatment.
确定醋酸阿比特龙（AA）治疗转移性去势抵抗性前列腺癌（mCRPC）患者的前3个月期间，血清嗜铬粒蛋白A（CgA）和神经元特异性烯醇化酶（NSE）变化的预后价值。
对40例mCRPC患者在基线时以及AA治疗3个月后测定血清CgA、NSE水平。观察指标为前列腺特异性抗原无进展生存期（PSA-PFS）、影像学无进展生存期（rPFS）和总生存期（OS）。
CgA水平与NSE水平不相关（P = 0.296）。多因素分析显示，CgA和NSE联合（≥1项指标阳性对比两项指标均阴性）以及AA治疗前3个月期间CgA和NSE升高联合（≥1项指标阳性对比两项指标均阴性）仍然是OS、rPFS和PSA-PFS的显著预测因素。
我们发现，AA治疗前3个月期间CgA和NSE升高以及基线CgA和NSE水平升高是接受AA治疗的mCRPC患者OS、rPFS和PSA-PFS的独立预后因素。这表明，连续评估CgA和NSE可能有助于临床医生区分哪些mCRPC患者能从AA治疗中获得最佳生存获益。
