5-α还原酶的表达与前列腺癌生物学行为相关性研究

Correlation between 5-α reductase and biological behavior of prostate cancer

目的探讨两型5-α还原酶表达情况与前列腺癌Gleason分级、血清前列腺特异性抗原(prostate specific antigen,PSA)浓度、TNM分期的相关性。方法选取2013至2014年间首都医科大学附属北京朝阳医院病理科前列腺癌的石蜡包埋组织40例,并收集患者基本信息、前列腺体积,术前PSA浓度,术后病理TNM分期,Gleason分级等。采用χ2检验和Spearman相关分析对2种5-α还原酶表达与病理分期、Gleason分级、PSA浓度及年龄等参数的关系进行分析。结果Ⅰ型5-α还原酶在前列腺癌组织中的表达明显高于癌旁组织(P<0.001),相反Ⅱ型5-α还原酶在癌旁组织的表达强于癌组织(P=0.002),Ⅰ型5-α还原酶在癌细胞中的表达与肿瘤的恶性程度呈正相关,Gleason分级越高,病理分期越高,Ⅰ型5-α还原酶的表达越强;Ⅰ型5-α还原酶表达和血PSA浓度及年龄呈正相关。结论 5-α还原酶在前列腺癌组织中呈现差异性表达的特点,前列腺癌组织内I型酶升高,II型酶降低;I型酶的表达与年龄、PSA浓度、病理分期及Gleason分级呈正相关,在老年人群前列腺癌的发生发展中可能具有重要的作用,I型酶对判断前列腺癌的生物学行为及预后可能具有一定意义。

Objective To investigate the correlation between the expression of two types of 5-αreductase and Gleason score,serum prostate-specific antigen（ PSA） concentration,and TNM stage in prostate cancer（ PCa）. Methods Paraffin-embedded PCa specimens of40 cases were collected in our hospital from 2013 to 2014. Other data of these patients were also collected including the basic information,prostate volume,preoperative serum PSA concentration,postoperative pathological TNM stage,Gleason score and so on. Chi-square test and Spearman rank correlation were used to analyze the correlation. Results The expression of type I 5-α reductase in PCa tissues was significantly stronger than that in the paraneoplastic tissues（ Chi-square test,P 〈0. 001）. On the contrary,the expression of type II 5-αreductase in the paraneoplastic tissues was stronger than that in PCa tissues（ Chi-square test,P = 0. 002）. expression of type I 5-αreductase in PCa epithelial cells was positively correlated with patient＇s age,serum PSA,the degree of tumor malignancy,Gleason score,and clinical stage. Conclusion Expression of 5-α reductases in PCa are different,type I enzyme is increased,and type II enzyme is decreased. The expression of type I enzyme is positively correlated with age,serum PSA concentration,pathological stage and Gleason score. These findings suggest that these enzymes may play an important role in the development and progression of prostate cancer in the elderly population. Type I enzyme may have a certain significance in judging the biological behavior and prognosis of prostate cancer.