细胞增殖而非细胞凋亡在解释新辅助内分泌治疗后对前列腺癌的病理影响方面的辅助价值。

Adjunctive value of cell proliferation but not of apoptosis to interpret pathologic effects on prostatic cancer after neoadjuvant endocrine therapy.

作者信息

Maeda O, Kinouchi T, Meguro N, Saiki S, Kuroda M, Usami M, Wada A, Kotake T

机构信息

Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.

出版信息

Jpn J Clin Oncol. 1998 Apr;28(4):262-6. doi: 10.1093/jjco/28.4.262.

DOI:10.1093/jjco/28.4.262

PMID:9657012

Abstract

BACKGROUND

The current histological evaluation of the effects of endocrine therapy has difficulty in distinguishing pathologic degeneration caused by androgen ablation from residual poorly differentiated tumor. Therefore, we examined the changes in cell proliferation and apoptosis before and after endocrine therapy and analyzed whether they correlated with pathologic effects and histological differentiation.

METHODS

Between January 1986 and December 1995, 52 patients with clinical stage B2 and C prostate cancer underwent radical prostatectomy after neoadjuvant endocrine therapy (median duration 3.8 months). Proliferative and apoptotic activities of pretreatment biopsy specimens and radical prostatectomy specimens were analyzed with MIB-1 monoclonal antibody and in situ end-labeling of fragmented DNA.

RESULTS

The mean proliferative index (PI) of radical prostatectomy specimens was significantly lower than that of biopsy specimens (P = 0.000003) and the decrease in PI after endocrine therapy was significantly related to histological differentiation (P = 0.014). There was a weak relationship between the decrease in PI after endocrine therapy and pathologic effects (P = 0.054), while in pathologically effective cases (Grades 2 and 3), three out of 16 (19%) showed a < 50% decrease in PI after endocrine therapy, and may be regarded as having poorly differentiated tumors. The mean apoptotic index (AI) of prostatectomy specimens tended to be higher than that of biopsy specimens (P = 0.054). The increase in AI after endocrine therapy was not related to histological differentiation and pathologic effects.

CONCLUSION

Pathologic effects caused by endocrine therapy may be in part misled by routine histopathologic staining and the change in PI may help in recognizing the pathologic effects of endocrine therapy and have adjunctive value for the interpretation of the effects of endocrine therapy.

摘要

背景

目前内分泌治疗效果的组织学评估难以区分雄激素去除引起的病理退变与残留的低分化肿瘤。因此，我们研究了内分泌治疗前后细胞增殖和凋亡的变化，并分析它们是否与病理效应和组织学分化相关。

方法

1986年1月至1995年12月期间，52例临床分期为B2和C期的前列腺癌患者在新辅助内分泌治疗（中位疗程3.8个月）后接受了根治性前列腺切除术。用MIB-1单克隆抗体和DNA片段原位末端标记法分析治疗前活检标本和根治性前列腺切除标本的增殖和凋亡活性。

结果

根治性前列腺切除标本的平均增殖指数（PI）显著低于活检标本（P = 0.000003），内分泌治疗后PI的降低与组织学分化显著相关（P = 0.014）。内分泌治疗后PI的降低与病理效应之间存在较弱的关系（P = 0.054），而在病理有效病例（2级和3级）中，16例中有3例（19%）内分泌治疗后PI降低<50%，可能被视为低分化肿瘤。前列腺切除标本的平均凋亡指数（AI）倾向于高于活检标本（P = 0.054）。内分泌治疗后AI的增加与组织学分化和病理效应无关。