Svenson Ulrika, Roos Göran, Wikström Pernilla
Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
Tumour Biol. 2017 Feb;39(2):1010428317692236. doi: 10.1177/1010428317692236.
Previous studies have suggested that leukocyte telomere length is associated with risk of developing prostate cancer. Investigations of leukocyte telomere length as a prognostic factor in prostate cancer are, however, lacking. In this study, leukocyte telomere length was investigated both as a risk marker, comparing control subjects and patient risk groups (based on serum levels of prostate-specific antigen, tumor differentiation, and tumor stage), and as a prognostic marker for metastasis-free and cancer-specific survival. Relative telomere length was measured by a well-established quantitative polymerase chain reaction method in 415 consecutively sampled individuals. Statistical evaluation included 162 control subjects without cancer development during follow-up and 110 untreated patients with newly diagnosed localized prostate cancer at the time of blood draw. Leukocyte telomere length did not differ significantly between control subjects and patients, or between patient risk groups. Interestingly, however, and in line with our previous results in breast and kidney cancer patients, relative telomere length at diagnosis was an independent prognostic factor. Patients with long leukocyte telomeres (⩾median) had a significantly worse prostate cancer-specific and metastasis-free survival compared to patients with short telomere length. In contrast, for patients who died of other causes than prostate cancer, long relative telomere length was not coupled to shorter survival time. To our knowledge, these results are novel and give further strength to our hypothesis that leukocyte telomere length might be used as a prognostic marker in malignancy.
以往研究表明，白细胞端粒长度与前列腺癌发病风险相关。然而，关于白细胞端粒长度作为前列腺癌预后因素的研究却较为缺乏。在本研究中，我们对白细胞端粒长度进行了两方面的研究，一是作为风险标志物，比较对照组与患者风险组（基于前列腺特异性抗原血清水平、肿瘤分化程度和肿瘤分期）；二是作为无转移生存期和癌症特异性生存期的预后标志物。采用成熟的定量聚合酶链反应方法，对415例连续采样个体的相对端粒长度进行了测量。统计评估纳入了162例随访期间未发生癌症的对照个体，以及110例在采血时新诊断为局限性前列腺癌的未经治疗患者。对照组与患者之间，以及患者风险组之间的白细胞端粒长度无显著差异。然而，有趣的是，与我们之前在乳腺癌和肾癌患者中的研究结果一致，诊断时的相对端粒长度是一个独立的预后因素。白细胞端粒长（⩾中位数）的患者与端粒短的患者相比，其前列腺癌特异性生存期和无转移生存期明显更差。相反，对于死于前列腺癌以外其他原因的患者，相对端粒长度长与较短的生存时间并无关联。据我们所知，这些结果是新颖的，进一步支持了我们的假设，即白细胞端粒长度可能用作恶性肿瘤的预后标志物。
