Yoshikawa H, Ikeuchi T, Kai Y
Department of Urology, Showa University Fujigaoka Hospital.
Nihon Hinyokika Gakkai Zasshi. 1996 Jul;87(7):956-63. doi: 10.5980/jpnjurol1989.87.956.
The anti-androgen therapy usually used to manage prostatic cancer is effective because the growth of adenocarcinoma of the prostate is influenced by androgens. However, some prostatic cancers do not respond to hormone therapy. Many studies have been conducted with the objective being to assess the responsiveness of prostatic cancer tissues by measuring the amount of androgen receptors (AR). The present study investigates the expression of AR in adenocarcinoma and in benign adenoma of the human prostate.
Formaline fixed paraffin sections of adenocarcinoma were prepared using 86 patients with primary prostatic cancer, seven patients with relapsed prostatic cancer, and 26 patients with BPH (as the control). Specimens were obtained by needle biopsy and immunohistochemical staining was performed.
The benign adenoma AR were stained in the nuclei of the glandular epithelial cells. The receptor-positive and receptor-negative cells were intermingled with the malignant prostatic cells. The labelling indexes (LI) of the androgen receptor stain values in adenocarcinoma of the prostate (57.8 +/- 14.5%) in 86 patients were significantly lower than benign adenoma (86.4 +/- 6.3%) (p = 0.0001). And the LI were decreased with the progress of grades in malignancy: 72.8 +/- 7.5% in well differentiated; 58.7 +/- 7.3% in moderately differentiated; and 41.4 +/- 8.2% in poorly differentiated adenocarcinoma (p = 0.0001). Moreover, LI in relapsed case, all of which were poorly differentiated (22.9 +/- 13.6%), were significantly lower than the LI values of the primary cancer cases with poorly differentiated adenocarcinoma (p = 0.0004). Responders to anti-androgen therapy had high AR positive rate (p = 0.0001) and weakly stained cases had a lower survival rate than strongly stained cases (p = 0.03).
These results suggest that the detection of AR with immunohistochemical study is useful for estimating the prognosis of the patients undergone anti-androgen therapy. And prostatic cancer cells are heterogeneously composed of clones of both androgen dependent and independent cancer cells before hormonal therapy is begun. And one reason why these tumors easily relapse with the progress of grades in hormonal therapy.
通常用于治疗前列腺癌的抗雄激素疗法是有效的，因为前列腺腺癌的生长受雄激素影响。然而，一些前列腺癌对激素疗法没有反应。许多研究旨在通过测量雄激素受体（AR）的量来评估前列腺癌组织的反应性。本研究调查AR在人前列腺腺癌和良性腺瘤中的表达。
使用86例原发性前列腺癌患者、7例复发性前列腺癌患者和26例良性前列腺增生患者（作为对照）制备腺癌的福尔马林固定石蜡切片。通过针吸活检获取标本并进行免疫组织化学染色。
良性腺瘤AR在腺上皮细胞核中染色。受体阳性和受体阴性细胞与恶性前列腺细胞混合。86例前列腺腺癌中雄激素受体染色值的标记指数（LI）（57.8±14.5%）显著低于良性腺瘤（86.4±6.3%）（p = 0.0001）。并且LI随着恶性程度分级的进展而降低：高分化腺癌中为72.8±7.5%；中分化腺癌中为58.7±7.3%；低分化腺癌中为41.4±8.2%（p = 0.0001）。此外，复发病例中的LI，所有病例均为低分化（22.9±13.6%），显著低于低分化腺癌原发性癌病例的LI值（p = 0.0004）。抗雄激素治疗的反应者具有较高的AR阳性率（p = 0.0001），染色弱的病例生存率低于染色强的病例（p = 0.03）。
这些结果表明，免疫组织化学检测AR有助于评估接受抗雄激素治疗患者的预后。并且在激素治疗开始前，前列腺癌细胞由雄激素依赖性和非依赖性癌细胞克隆异质性组成。这是这些肿瘤在激素治疗过程中容易随着分级进展而复发的一个原因。
