Miyata Yasuyoshi, Nakamura Yuichiro, Yasuda Takuji, Matsuo Tomohiro, Ohba Kojiro, Furusato Bungo, Fukuoka Junya, Sakai Hideki
Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Prostate. 2017 Oct;77(14):1408-1415. doi: 10.1002/pros.23402. Epub 2017 Aug 28.
The effects of neoadjuvant hormonal therapy (NHT) on pathological features and lymphangiogenesis in patients with prostate cancer (PCa) for each pre-operative risk classification are unclear.
To clarify the anti-cancer effects of NHT, we investigated 153 patients (non-NHT group = 80 and NHT group = 73) who underwent radical prostatectomy (RP) in Nagasaki University Hospital. Lymph vessel density and area (evaluated by D2-40-positive vessels), vascular endothelial growth factor (VEGF)-C and VEGF-D expressions, and biochemical recurrence (BCR)-free survival were compared between these two groups for each D'Amico risk classification (low = 33, intermediate = 58, high = 62 patients).
In low-risk PCa patients, the risks of lymph vessel invasion and BCR were significantly higher in the NHT group than in the non-NHT group (P = 0.040 and 0.022, respectively). Such significant difference was not seen in the intermediate- or high-risk PCa groups. Lymph vessel density of the peri-tumoral and intra-tumoral areas and the lymph vessel area were significantly higher (P < 0.001) in the NHT group than in the non-NHT group in low-risk PCa. In regard to the expression of VEGF-C or VEGF-D, significant difference was not detected in low-risk PCa.
NHT stimulated cancer cell progression and BCR via up-regulation of lymphangiogenesis-related parameters in patients with low-risk PCa. Although VEGF-C and VEGF-D expressions were not changed by NHT, lymph vessel density and area were increased in low-risk PCa patients. We suggest that NHT for patients with low-risk PCa may have a high risk for BCR after RP.
新辅助激素治疗（NHT）对前列腺癌（PCa）患者术前各风险分类的病理特征和淋巴管生成的影响尚不清楚。
为阐明NHT的抗癌作用，我们调查了在长崎大学医院接受根治性前列腺切除术（RP）的153例患者（非NHT组=80例，NHT组=73例）。对这两组患者按D'Amico风险分类（低风险=33例，中风险=58例，高风险=62例）比较淋巴管密度和面积（通过D2-40阳性血管评估）、血管内皮生长因子（VEGF）-C和VEGF-D表达以及无生化复发（BCR）生存率。
在低风险PCa患者中，NHT组的淋巴管侵犯风险和BCR风险显著高于非NHT组（分别为P=0.040和0.022）。在中风险或高风险PCa组中未观察到这种显著差异。在低风险PCa中，NHT组的肿瘤周围和肿瘤内区域的淋巴管密度以及淋巴管面积显著高于非NHT组（P<0.001）。关于VEGF-C或VEGF-D表达，在低风险PCa中未检测到显著差异。
NHT通过上调低风险PCa患者淋巴管生成相关参数刺激癌细胞进展和BCR。尽管NHT未改变VEGF-C和VEGF-D表达，但低风险PCa患者的淋巴管密度和面积增加。我们认为，低风险PCa患者接受NHT后行RP可能有较高的BCR风险。
