Zharinov Gennady M, Bogomolov Oleg A, Neklasova Natalia Yu, Raskin Grigory A, Chepurnaya Irina V, Bugrov Sergey N, Anisimov Vladimir N
Department of Radiotherapy, The Russian Research Center of Radiology and Surgical Technologies, Ministry of Health of Russian Federation, St. Petersburg, Russia.
Department of Carcinogenesis and Oncogerontology, N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russian Federation, St. Petersburg, Russia.
Oncotarget. 2019 Aug 20;10(49):5020-5027. doi: 10.18632/oncotarget.27088.
The goal of this paper was to estimate the predictive value of kinetic parameters of tumor growth in 109 prostatic cancer (PCa) patients with the morphologically verified diagnosis. The cell loss factor, calculated on the basis of Ki-67 values, and the PSA doubling time, proved to be an important prognostic parameter. A cumulative comparative analysis of these criteria, depending on the prevalence of the tumor process, indicates that the level of cell loss significantly decreases with increasing tumor stage ( = 110), and the growth rate of the tumor significantly increases ( = 110). In the multivariate prognostic model, the CLF is an independent predictor of tumor-specific survival along with the stage of PCa. For each patient of the study group were as follows. The level of Ki-67 expression in biopsies of adenocarcinoma of the prostate gland was estimated. Also, in the selected group of patients, based on the available data on the kinetics of the prostatic specific antigen (PSA), the initial time of doubling of PSA was determined. The obtained values of the actual tumor growth rate and the cell loss factor (CLF) were compared with the parameters characterizing the tumor state (stage, Gleason score, PSA level at diagnosis) and tumor-specific survival rates. Inclusion of proliferative activity factors in nomograms and prognostic models will increase their prognostic value and practical significance. Further prospective studies are needed to analyze the actual growth rate of PCa and evaluate its proliferative activity.
本文的目的是评估109例经形态学确诊的前列腺癌（PCa）患者肿瘤生长动力学参数的预测价值。基于Ki-67值计算的细胞丢失因子和前列腺特异抗原（PSA）倍增时间被证明是重要的预后参数。根据肿瘤进程的发生率对这些标准进行的累积比较分析表明，细胞丢失水平随肿瘤分期增加而显著降低（P = 1×10），而肿瘤生长速率显著增加（P = 1×10）。在多变量预后模型中，细胞丢失因子（CLF）与PCa分期一样，是肿瘤特异性生存的独立预测因子。研究组中每位患者的情况如下。评估前列腺腺癌活检中Ki-67的表达水平。此外，在选定的患者组中，根据前列腺特异抗原（PSA）动力学的现有数据，确定PSA的初始倍增时间。将获得的实际肿瘤生长速率和细胞丢失因子（CLF）值与表征肿瘤状态的参数（分期、Gleason评分、诊断时的PSA水平）以及肿瘤特异性生存率进行比较。将增殖活性因子纳入列线图和预后模型将提高其预后价值和实际意义。需要进一步的前瞻性研究来分析PCa的实际生长速率并评估其增殖活性。
