Grob B M, Schellhammer P F, Brassil D N, Wright G L
Department of Microbiology and Immunology, Eastern Virginia Medical School, Norfolk.
Urology. 1994 Oct;44(4):525-9. doi: 10.1016/s0090-4295(94)80051-0.
To determine if tissue expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and a prostate-associated monoclonal antibody (TURP-27) is retained after irradiation therapy and to compare these results with serum levels.
Immunohistochemical tests were performed on prostatic tissue obtained by needle biopsy or transurethral resection prior to and following definitive irradiation therapy for clinically localized prostatic carcinoma. PSA, PAP, and TURP-27 were studied. Results were compared with serum PSA and PAP values.
All 20 preirradiation specimens stained positively for PSA and PAP; 19 of 20 stained for TURP-27. All 5 of the initial post-treatment biopsy specimens that showed recurrent tumor stained for all 3 markers. In 2 cases, staining for the 3 markers was greatly diminished. Only 8 of 15 post-treatment biopsy-negative specimens stained for all 3 markers. Six of 15 demonstrated loss of tissue expression for all 3 antigens. One specimen stained for PAP and TURP-27 but failed to stain for PSA. Serum PSA levels paralleled tissue expression in recurrent tumor specimens. However, 3 of the post-treatment biopsy-positive cases with PAP expressing tissue had normal serum PAP levels.
No cases of recurrent tumor with marker-negative tissue were identified. However, benign epithelial prostate cells appear to sustain sufficient damage from irradiation to lose the capacity to produce certain proteins. Diminished contribution of benign glands to circulating PSA, in addition to decreased expression in malignant tissues, may explain the lower than anticipated serum PSA levels in patients who progress after irradiation therapy.
确定前列腺特异性抗原（PSA）、前列腺酸性磷酸酶（PAP）和一种前列腺相关单克隆抗体（TURP - 27）在放射治疗后组织表达是否保留，并将这些结果与血清水平进行比较。
对临床局限性前列腺癌进行根治性放射治疗前后通过穿刺活检或经尿道切除术获取的前列腺组织进行免疫组织化学检测。研究了PSA、PAP和TURP - 27。将结果与血清PSA和PAP值进行比较。
所有20份放疗前标本PSA和PAP染色均为阳性；20份中有19份TURP - 27染色阳性。所有5份显示复发肿瘤的初始治疗后活检标本3种标志物染色均为阳性。2例中，3种标志物的染色大大减弱。15份治疗后活检阴性标本中只有8份所有3种标志物染色均为阳性。15份中有6份显示所有3种抗原的组织表达缺失。1份标本PAP和TURP - 27染色阳性，但PSA染色阴性。血清PSA水平与复发肿瘤标本中的组织表达平行。然而，3例PAP表达组织的治疗后活检阳性病例血清PAP水平正常。
未发现标志物阴性组织的复发肿瘤病例。然而，良性前列腺上皮细胞似乎受到放射的足够损伤而失去产生某些蛋白质的能力。除了恶性组织中表达降低外，良性腺体对循环PSA的贡献减少可能解释了放射治疗后病情进展患者血清PSA水平低于预期的原因。
