前列腺癌组织PLAGL2表达临床意义探讨

Expression and clinical significance of PLAGL2 in prostate cancer

目的 多形性腺瘤基因样蛋白2(pleomorphic adenoma gene-like protein 2,PLAGL2)作为细胞核内的转录因子可促进肿瘤发生,但其在前列腺癌中表达及临床意义尚属未知。本研究探讨前列腺癌(prostate cancer,PCa)组织中PLAGL2表达,并分析PLAGL2与前列腺癌临床病理参数关系及淋巴结转移影响因素。方法 收集2010-01-01-2015-12-31中南大学湘雅医学院附属株洲医院泌尿外科103例前列腺癌患者行根治性前列腺切除术后病理标本及临床资料,选取50例良性前列腺增生病理标本及20例阳性淋巴结作为对照。采用组织芯片方式收集组织标本,免疫组化染色法检测PLAGL2表达,分析PLAGL2表达同前列腺癌患者临床病理参数关系及淋巴结转移影响因素。结果 前列腺癌PLAGL2阳性表达率(80.6%)高于良性前列腺增生(22.0%),χ2=55.003,P<0.001。PLAGL2表达水平与前列腺特异抗原(prostate specific antigen,PSA)水平(χ2=19.652,P=0.003)、Gleason评分(χ2=60.920,P<0.001)、PI-RADS评分(χ2=13.147,P=0.004)、临床分期(χ2=38.203,P<0.001)、淋巴结转移(χ2=36.875,P<0.001)、包膜侵犯(χ2=9.943,P=0.017)和精囊侵犯(χ2=8.355,P=0.031)有关联。前列腺癌盆腔淋巴结转移与PSA水平(χ2=7.828,P=0.022)、Gleason评分(χ2=39.417,P<0.001)、PI-RADS评分(χ2=4.820,P=0.034)、临床分期(χ2=19.495,P<0.001)、包膜(χ2=9.193,P=0.004)、精囊侵犯(χ2=10.473,P=0.003)和PLAGL2表达水平(χ2=36.875,P<0.001)有关联。Logistic回归分析显示,PLAGL2表达水平与Gleason评分是前列腺癌发生淋巴结转移的独立危险因素。结论 PLAGL2在前列腺癌组织中异常高表达,并与前列腺癌淋巴结转移相关,可能是预测淋巴结转移的重要因子。

OBJECTIVE To investigate the expression of pleomorphic adenoma gene-like protein(PLAGL2)in prostate cancer(PCa),and to explore the relationship between PLAGL2and clinicopathological parameters of prostate cancerand the influencing factors of lymph node metastasis.METHODS Collection of pathological specimens and clinical data of103patients with prostate cancer undergoing radical prostatectomy in the Department of Urology,Affiliated Zhuzhou Hospital of Xiangya Medical College,Central South University from January 1,2010to December 31,2015.Fifty pathologicalspecimens of benign prostatic hyperplasia were selected and 20positive lymph nodes were used as control.The expressionof PLAGL2was detected by immunohistochemical staining,and the relationship between the expression of PLAGL2andthe clinicopathological parameters of prostate cancer patients and the influencing factors of lymph node metastasis wereanalyzed.RESULTS The positive expression rates of prostate cancer(80.6%)were higher than that of benign prostatichyperplasia(22.0%),χ2=55.003,P<0.001.PLAGL2expression level was associated with PSA level(χ2=19.652,P=0.003),Gleason score(χ2=60.920,P<0.001),PI-RADS score(χ2=13.147,P=0.004),clinical stage(χ2=38.203,P<0.001),lymph node metastasis(χ2=36.875,P<0.001),envelope invasion(χ2=9.943,P=0.017)and seminal vesicle invasion(χ2=8.355,P=0.031).Pelvic lymph node metastasis was associated with PSA(χ2=7.828,P=0.022),Gleason score(χ2=39.417,P<0.001),PI-RADS score(χ2=4.820,P=0.034),clinical stage(χ2=19.495,P<0.001),capsule(χ2=9.193,P=0.004),seminal vesicle invasion(χ2=10.473,P=0.003)and PLAGL 2expression level(χ2=36.875,P<0.001).Logistic regression analysis showed that the expression level of PLAGL2and Gleason score wereindependent risk factors for lymph node metastasis of prostate cancer.CONCLUSION PLAGL2is highly expressed inprostate cancer tissues and is associated with lymph node metastasis of prostate cancer,which may be an important factorpredicting lymph node metastasis.