激素受体及CgA表达与去势抵抗性前列腺癌的关系

Relationship between hormone receptor and CgA expression and castration-resistant prostate cancer

目的探讨嗜铬粒蛋白A(chromogranin A, CgA)、AR、ER、PR表达与前列腺癌(prostate cancer, PCa)去势抵抗的关系。方法 收集行TURP术有临床随访资料的63例PCa标本,采用免疫组化SP法检测CgA、AR、ER、PR在PCa组织中的表达情况,并分析去势抵抗与PCa各临床病理特征、CgA、AR、ER、PR的关系,以及CgA与PCa各临床病理特征、AR、ER、PR的关系。结果 去势抵抗性PCa的发生与PCa PSA≥20 ng/mL、Gleason评分8~10、CgA阳性、AR阴性具有相关性,CgA阳性与PCa PSA≥20 ng/mL、Gleason评分8~10、AR阴性具有相关性。ER、PR表达与去势抵抗性PCa的发生及CgA表达无相关性。多因素Logistic回归分析结果显示Gleason评分是进展为去势抵抗性PCa的独立危险因素,AR是CgA的独立危险因素。结论 CgA表达与前列腺的恶性程度呈正相关,AR表达与前列腺的恶性程度呈负相关。Gleason评分、CgA及AR与PCa去势抵抗密切相关,监测CgA与AR的表达情况,结合Gleason评分对PCa的治疗方案选择和预后判断有一定的临床指导意义。

Purpose To explore the relationship between expression of chromogranin A (CgA), AR, ER, PR and castration resistance in prostate cancer (PCa). Methods The sixty-three cases of PCa with clinical follow-up data were collected for TURP surgery. The expression of CgA, AR, ER and PR in PCa tissues was detected by immunohistochemistry, and the relationship between c clinical pathological parameters, CgA, AR, ER and PR was analyzed, and the relationship of CgA with clinicopathologic features of PCa, AR, ER and PR was also studied. Results PCa had a correlation between PSA≥20 ng/mL, Gleason score of 8-10, CgA positivity, AR negativity and the occurrence of castration resistance PCa, while CgA positivity was correlated with PSA ≥20 ng/mL, Gleason score of 8-10 and AR negativity. Positive expression of ER and PR had no correlation with the occurrence of castration resistance PCa and positive expression of CgA. Multivariate Logistic regression analysis showed that Gleason score was an independent risk factor for developing castration-resistant PCa, and AR was an independent risk factor for CgA. Conclusion Positive CgA expression is positively correlated with malignancy of prostate and positive AR expression is negatively correlated with malignancy of prostate. Gleason score, CgA and AR are closely related to the castration resistance of PCa. Monitoring the expression of CgA and AR, combined with Gleason score, has certain clinical guiding significance for the selection of treatment plan and prognosis judgment of PCa.