Bauer J J, Srivastava S, Connelly R R, Sesterhenn I A, Preston D M, McLeod D G, Moul J W
Department of Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
Urology. 1998 Jun;51(6):970-6. doi: 10.1016/s0090-4295(98)00103-4.
Prostate cancer (PCa) has a familial predisposition imparting an increased risk of developing the disease in those with a family history. The pathologic characteristics are similar to sporadic cases; however, the disease-free survival rates of hereditary PCa have recently been disputed, with one major study suggesting that familial cases have higher recurrence rates. Our study seeks to support or refute this association and to evaluate the genetic biomarkers p53, bcl-2, Ki-67, and neovascularity between familial and sporadic disease.
We retrospectively reviewed data of 573 patients who underwent radical prostatectomy over an 11-year period. Of these, 474 patients had known family history data. Univariable statistical analysis using the Pearson chi-square test and Kaplan-Meier disease-free survival analysis was performed to identify any correlation between the tested variables and family history. Smaller subsets of this cohort that had available archival material for immunohistochemical staining and family history data were analyzed in a similar manner.
The preoperative variables (prostate-specific antigen, prostatic acid phosphatase, clinical stage, highest biopsy Gleason sum, and glandular differentiation) and postoperative variables (stage, highest Gleason sum, and glandular differentiation) did not correlate with family history. Kaplan-Meier disease-free survival analysis revealed no differences between sporadic and familial cases. The analysis of p53, bcl-2, Ki-67, and angiogenesis revealed that only increasing p53 expression and positive family history of PCa approached significance (P = 0.057).
Prognostic variables routinely used in PCa and selected genetic biomarker immunostaining abnormalities are not significantly different in men with and without a family history of PCa. Disease-free survival after radical prostatectomy is also unaffected by family history.
前列腺癌（PCa）具有家族易感性，使有家族病史者患该病的风险增加。其病理特征与散发性病例相似；然而，遗传性PCa的无病生存率最近受到质疑，一项主要研究表明家族性病例的复发率更高。我们的研究旨在支持或反驳这种关联，并评估家族性和散发性疾病之间的基因生物标志物p53、bcl-2、Ki-67和新生血管形成情况。
我们回顾性分析了11年间接受根治性前列腺切除术的573例患者的数据。其中，474例患者有已知的家族病史数据。使用Pearson卡方检验和Kaplan-Meier无病生存分析进行单变量统计分析，以确定测试变量与家族病史之间的任何相关性。对该队列中较小的子集进行了类似的分析，这些子集有可用于免疫组织化学染色的存档材料和家族病史数据。
术前变量（前列腺特异性抗原、前列腺酸性磷酸酶、临床分期、最高活检Gleason评分总和以及腺分化）和术后变量（分期、最高Gleason评分总和以及腺分化）与家族病史无关。Kaplan-Meier无病生存分析显示散发性和家族性病例之间没有差异。对p53、bcl-2、Ki-67和血管生成的分析表明，只有p53表达增加和PCa家族阳性史接近显著水平（P = 0.057）。
在有和没有PCa家族病史的男性中，PCa常规使用的预后变量和选定的基因生物标志物免疫染色异常没有显著差异。根治性前列腺切除术后的无病生存也不受家族病史的影响。
