Morphological Analysis Laboratory, Kanagawa Cancer Center Research Institute, Yokohama 241-8515, Kanagawa, Japan.
Department of Urology, Kanagawa Cancer Center, Yokohama 241-8515, Kanagawa, Japan.
Int J Mol Sci. 2024 Aug 17;25(16):8970. doi: 10.3390/ijms25168970.
Biochemical recurrence is a process that progresses to castration-resistant prostate cancer (CRPC) and prediction of biochemical recurrence is useful in determining early therapeutic intervention and disease treatment. Prostate cancer is surrounded by adipose tissue, which secretes adipokines, affecting cancer progression. This study aimed to investigate the correlation between blood adipokines and CRPC biochemical recurrence. We retrospectively analyzed the clinical data, including preoperative serum adipokine levels, of 99 patients with pT3a pN0 prostate cancer who underwent proctectomy between 2011 and 2019. The primary outcome was biochemical recurrence (prostate-specific antigen: PSA > 0.2). We identified 65 non-recurrences and 34 biochemical recurrences (one progressed to CRPC). The initial PSA level was significantly higher ( = 0.006), but serum adiponectin ( = 0.328) and leptin ( = 0.647) levels and their ratio ( = 0.323) were not significantly different in the biochemical recurrence group compared with the non-recurrence group. In contrast, significantly more biochemical recurrences were observed in the group with adiponectin < 6 μg/mL and Leptin < 4 ng/mL ( = 0.046), initial PSA > 15 ng/mL, clinical Gleason pattern ≥ 4, and positive resection margin. A significant difference was also observed in the multivariate analysis (hazard ratio: 4.04, 95% confidence interval: 1.21-13.5, = 0.0232). Thus, low preoperative serum adiponectin and high leptin levels were significantly associated with biochemical recurrence in adipose tissue-invasive prostate cancer, suggesting that they may be useful predictors of biochemical recurrence. Further studies with larger cases are needed to increase the validity of this study.
生化复发是进展为去势抵抗性前列腺癌（CRPC）的过程，预测生化复发有助于确定早期治疗干预和疾病治疗。前列腺癌周围有脂肪组织，脂肪组织分泌脂肪因子，影响癌症的进展。本研究旨在探讨血液脂肪因子与 CRPC 生化复发的相关性。我们回顾性分析了 2011 年至 2019 年间接受直肠前列腺切除术的 99 例 pT3a pN0 前列腺癌患者的临床资料，包括术前血清脂肪因子水平。主要结局为生化复发（前列腺特异抗原：PSA＞0.2ng/ml）。我们发现 65 例无复发，34 例生化复发（1 例进展为 CRPC）。生化复发组初始 PSA 水平显著较高（ = 0.006），但与无复发组相比，血清脂联素（ = 0.328）和瘦素（ = 0.647）水平及其比值（ = 0.323）差异无统计学意义。相反，在脂联素＜6μg/ml 和瘦素＜4ng/ml（ = 0.046）、初始 PSA＞15ng/ml、临床 Gleason 模式≥4 和阳性切缘的患者中，观察到更多的生化复发。多变量分析也显示出显著差异（风险比：4.04，95%置信区间：1.21-13.5， = 0.0232）。因此，术前血清脂联素水平低和瘦素水平高与脂肪组织浸润性前列腺癌的生化复发显著相关，提示它们可能是生化复发的有用预测因子。需要更大样本量的研究来提高本研究的有效性。
