非那雄胺对前列腺癌血管形成的影响

The effect of finasteride on angiogenesis of prostate cancer

目的观察长期服用非那雄胺对前列腺癌血管形成的影响。方法44例T1b^T4期前列腺癌患者,年龄56~86岁,平均72岁。12例诊断前列腺癌前曾用非那雄胺(5 mg/d)3~24个月,平均9个月,设为非那雄胺组,32例未服用非那雄胺者为对照组。组织标本来自前列腺穿刺或经尿道前列腺电切,采用免疫组织化学染色方法观察前列腺癌组织中微血管密度(MVD)及血管内皮生长因子(VEGF)、低氧诱导因子1α(H IF-1α)的表达情况。结果对照组前列腺癌组织中MVD为66.8±17.7,非那雄胺组为48.4±10.8,差异性有统计学意义(P<0.05)。非那雄胺组前列腺癌组织中H IF-1α及VEGF表达阳性率分别为33%、42%,均显著低于对照组的69%、75%(P<0.05)。结论非那雄胺可能通过抑制前列腺癌H IF-1α、VEGF表达而抑制前列腺癌血管形成,这可能是非那雄胺防治前列腺癌的机理之一。

Objective To observe the effect of long-term use of finasteride on angiogenesis of prostate cancer. Methods A total of 44 patients （mean age,72 years; age range, 56 -86 years） with T1b - T4 stage prostate cancer were included. Among them, 12 patients had taken finasteride at 5mg/d for 3 to 24 months （mean,9 months） ; the reemaining 32 patients with no use of finasteride served as controls. The expression of CD34, hypoxia-inducible factor 1 α （ HIF-1 α） , and vascular endothelial growth factor （ VEGF ） were detected by immunohistochemical assay in the tissue samples of prostate cancer and microvessel density （MVD） was analyzed by staining with antibodies to CD34. Results A lower concentration of MVD （48.4 -10.8） in prostate cancer patients treated with finasteride was observed compared with that in the controls （66.8 - 17.7） , showing a significant difference （P 〈 0.05 ）. The positive rates of HIF-1α and VEGF expression were significantly lower in prostate cancer patients treated with finasteride （33% and 42% ） than those in the controls （69% and 75% ,P 〈 0.05 for both）. Conclusions Decreased expression of HIF-1α and VEGF by finasteride may inhibit angiogenesis in prostate cancer. This may be one of the important mechanisms of finasteride in preventing and inhibiting prostate cancer.