前列腺癌中雄激素受体及血清PSA、FPSAR表达水平的临床意义

Expression and significance of androgen receptor,serum PSA and FPSAR in prostate cancer

目的探究雄激素受体(AR)及血清前列腺特异抗原(PSA)、游离前列腺特异抗原百分率(FPSAR)在前列腺癌中的表达及其与病理特征、预后的关系。方法选择2017年7月至2019年9月崇州市人民医院收治的152例前列腺癌患者纳入前列腺癌组,另择同期行手术治疗的100例前列腺增生患者作为增生组。采用免疫组化及放射免疫法分别测定前列腺组织AR的表达及血清PSA水平,计算FPSAR值。结果前列腺癌组患者组织AR表达阳性率显著低于增生组(x^(2)=17.934,P<0.05),血清PSA显著高于增生组(t=26.919,P<0.05),FPSAR水平显著低于增生组(t=7.327,P<0.05),差异均有统计学意义。组织中AR的表达、血清PSA水平与前列腺癌患者分化程度、临床分期、Gleason评分、骨转移相关,差异均有统计学意义(P<0.05),血清FPSAR水平与临床分期、Gleason评分、骨转移相关,差异均有统计学意义(P<0.05)。单因素分析显示,Gleason评分、临床分期、骨转移、血清PSA水平、FPSAR水平、组织AR表达情况是影响前列腺癌患者生存时间的因素(P<0.05)。多因素分析显示,骨转移、血清PSA水平及组织AR表达是影响前列腺癌患者预后的独立影响因素(P<0.05)。结论前列腺癌组织AR表达及血清FPSAR水平降低,血清PSA水平升高,且与肿瘤侵袭性及预后存在一定关系。

Objective To explore the expression of androgen receptor(AR),serum prostate specific antigen(PSA)and free prostate specific antigen fraction(FPSAR)in prostate cancer and their relationship with pathological features and the prognosis.Methods 152 patients with prostate cancer who were admitted to the hospital between July 2017 and September2019 were selected and included in the prostate cancer group.Meanwhile,100 patients with benign prostatic hyperplasia(BPH)treated with surgery in the hospital during the same period were selected and included in BPH group.The expression of AR and serum PSA level in prostate tissues were measured by immunohistochemistry and radioimmunoassay,respectively.Besides,the FPSAR value was calculated.Results The positive expression rate of AR and FPSAR level in prostate cancer group were significantly lower than those in BPH group(x^(2)/t=17.934/7.327,P<0.05),while serum PSA level was significantly higher than that in BPH group(t=26.919,P<0.05).The expression of AR and serum PSA levels in tissues were correlated with the differentiation degree,clinical staging,Gleason score and bone metastasis in patients with prostate cancer(P<0.05).Serum FPSAR level was correlated with clinical staging,Gleason score and bone metastasis(P<0.05).Univariate analysis showed that Gleason score,clinical staging,bone metastasis,serum PSA level,FPSAR level and the expression of AR were factors affecting the survival time of patients with prostate cancer(P<0.05).Multivariate analysis showed bone metastasis,serum PSA levels and expression of AR were independent factors affecting the prognosis of patients with prostate cancer(P<0.05).Conclusion The expression of AR and FPSAR level were decreased,while serum PSA level was elevated in prostate tissues.Besides,there was certain correlation with tumor invasion and prognosis.