Noordzij M A, Bogdanowicz J F, van Krimpen C, van der Kwast T H, van Steenbrugge G J
Department of Urology, Erasmus University, Rotterdam, The Netherlands.
J Urol. 1997 Nov;158(5):1880-4; discussion 1884-5. doi: 10.1016/s0022-5347(01)64157-0.
We determined the prognostic value of oncoprotein bcl-2 and androgen receptor expression in pretreatment transurethral resection specimens of hormonally treated prostate cancer patients.
A total of 68 pretreatment transurethral resection specimens, 30 radical prostatectomy specimens and 21 palliative transurethral resection specimens with androgen independent prostate cancer was stained with a monoclonal antibody against bcl-2. Androgen receptor immunohistochemistry was performed on pretreatment transurethral resection specimens only. Results were scored semiquantitatively and were correlated with tumor stage and grade and with the occurrence of clinical progression or tumor related death.
Bcl-2 expression by adenocarcinoma cells was found in 32, 17 and 24% of pretreatment transurethral resection, radical prostatectomy and palliative transurethral resection specimens, respectively. The bcl-2 scores did not correlate with tumor stage or grade. Androgen receptor was expressed in 88% of pretreatment transurethral resection specimens. Androgen receptor scores were marginally related to tumor grade, but not to tumor stage. A prognostic value of bcl-2 or androgen receptor in pretreatment transurethral resection specimens was not found. When a combined bcl-2/androgen receptor score was used, this parameter was an independent prognostic marker to predict clinical progression with Gleason grade and stage classification. Gleason grade was the only independent prognostic marker to predict tumor related death.
The expression of bcl-2 and androgen receptor in pretreatment prostate cancer specimens is not related to the prognosis of hormonally treated prostate cancer. Bcl-2 expression is not increased in endocrine therapy resistant prostate cancer. Surprisingly, a combined bcl-2/androgen receptor score acts as an independent prognosticator for clinical progression.
我们确定了癌蛋白bcl-2和雄激素受体表达在接受激素治疗的前列腺癌患者治疗前经尿道切除标本中的预后价值。
总共68份治疗前经尿道切除标本、30份前列腺癌根治术标本以及21份雄激素非依赖性前列腺癌的姑息性经尿道切除标本，用抗bcl-2单克隆抗体染色。仅对治疗前经尿道切除标本进行雄激素受体免疫组织化学检测。结果进行半定量评分，并与肿瘤分期、分级以及临床进展或肿瘤相关死亡的发生情况相关联。
腺癌组织细胞中bcl-2表达分别在32%、17%和24%的治疗前经尿道切除标本、前列腺癌根治术标本和姑息性经尿道切除标本中被发现。bcl-2评分与肿瘤分期或分级无关。88%的治疗前经尿道切除标本中表达雄激素受体。雄激素受体评分与肿瘤分级略有相关，但与肿瘤分期无关。未发现治疗前经尿道切除标本中bcl-2或雄激素受体具有预后价值。当使用联合bcl-2/雄激素受体评分时，该参数是预测临床进展以及Gleason分级和分期分类的独立预后标志物。Gleason分级是预测肿瘤相关死亡的唯一独立预后标志物。
治疗前前列腺癌标本中bcl-2和雄激素受体的表达与接受激素治疗的前列腺癌的预后无关。内分泌治疗耐药的前列腺癌中bcl-2表达未增加。令人惊讶的是，联合bcl-2/雄激素受体评分可作为临床进展的独立预后指标。
