Murray Nigel P, Aedo Socrates, Fuentealba Cynthia, Reyes Eduardo, Jacob Omar
Faculty of Medicine, University Finis Terrae, Providencia, Santiago, Chile.
Urology Service, Hospital de Carabineros de Chile, Nunoa, Santiago Chile.
Turk J Urol. 2017 Dec;43(4):456-461. doi: 10.5152/tud.2017.60251. Epub 2017 Dec 1.
To determine the prognostic value of secondary circulating prostate cells (CPCs) in men with pT2 prostate cancer treated with radical prostatectomy.
Prospective observational study was performed in men with pathologically confined prostate cancer who had been treated with radical prostatectomy. CPCs were obtained by differential gel centrifugation from 8 mL venous blood and identified by standard immunocytochemistry using anti-Prostate Specific Antigen (PSA) monoclonal antibody. A positive test was defined as ≥1 PSA staining cell/blood sample. Biochemical failure was defined as a serum PSA >0.2 ng/mL. Age, PSA at diagnosis, pT2a versus pT2b/c, Gleason score and the presence/absence of CPCs were compared with patient outcomes using Kaplan-Meier curves and Cox's hazard model.
Hundred and ninety-one men participated in the study, 107 (44.0%) had pT2b/c disease, 25 (13.1%) had a Gleason score ≥7, and 39 (20.4%) were positive for CPCs. Biochemical failure occurred in 39 (20.4%) patients which was associated with a Gleason score ≥ 7 and CPCs (+). Survival rates at 3, 5 and 10 years for men with CPC (-) and CPC (+) were 100%, 100% and 89.6%, and 74.4%, 64.1% and 18.5% respectively (HR: 18.70). The median time to failure was 5.1 years in CPC (+) men versus 8.1 years in CPC (-) patients.
Secondary CPC is a marker for minimal residual disease and it is associated with a worse prognosis. The lead time to failure over serum PSA is approximately 5 years. However they do not define whether the failure is local or systemic.
确定接受根治性前列腺切除术的pT2期前列腺癌男性患者中，继发性循环前列腺细胞（CPCs）的预后价值。
对接受根治性前列腺切除术的病理局限型前列腺癌男性患者进行前瞻性观察研究。通过差异凝胶离心法从8 mL静脉血中获取CPCs，并使用抗前列腺特异性抗原（PSA）单克隆抗体通过标准免疫细胞化学方法进行鉴定。阳性检测定义为每个血样中≥1个PSA染色细胞。生化复发定义为血清PSA>0.2 ng/mL。使用Kaplan-Meier曲线和Cox风险模型将年龄、诊断时的PSA、pT2a与pT2b/c、Gleason评分以及CPCs的有无与患者预后进行比较。
191名男性参与了该研究，107名（44.0%）患有pT2b/c期疾病，25名（13.1%）Gleason评分≥7，39名（20.4%）CPCs呈阳性。39名（20.4%）患者发生生化复发，这与Gleason评分≥7和CPCs（+）相关。CPCs（-）和CPCs（+）男性患者3年、5年和10年的生存率分别为100%、100%和89.6%，以及74.4%、64.1%和18.5%（风险比：18.70）。CPCs（+）男性患者的中位复发时间为5.1年，而CPCs（-）患者为8.1年。
继发性CPCs是微小残留疾病的标志物，与较差的预后相关。相对于血清PSA，复发的提前期约为5年。然而，它们无法确定复发是局部性还是全身性的。
