前列腺癌患者血皮质醇胆固醇变化及其意义

目的 探讨前列腺癌雄激素非依赖发生的机制.方法 根据临床疗效及PSA变化将前列腺癌(PCa)患者分为激素依赖和激素非依赖两组,分别应用放射免疫法和标准酶法检测血皮质醇和总胆固醇(TC)水平,并与前列腺增生(BPH)患者相对比.结果 血皮质醇水平PCa患者明显高于BPH患者(P<0.01),雄激素非依赖者明显高于雄激素依赖者(P<0.05).总胆固醇水平PCa高于BPH(P<0.05),均高于正常值,激素依赖和非依赖之间无明显差别.结论 胆固醇是前列腺癌的促发因素,皮质醇与前列腺癌激素非依赖的发生有密切关系.     

AR GR表达与前列腺癌生物学行为的关系

目的 探讨不同病理前列腺组织中雄激素受体(AR)、糖皮质激素受体(GR)的表达变化及与前列腺癌生物学行为的关系.方法 选取15例人正常前列腺(NP)组织、25例良性前列腺增生(BPH)组织、57例前列腺癌(PCa)组织,对PCa进行Gieason分级,并根据临床雄激素阻断治疗效果分为雄激素依赖组(ADPC,n=39)和雄激素非依赖组(AIPC,n=18),免疫组化检测手术标本AR、GR、PSA的表达并分析其与Gleason分级的关系.结果 从NP、BPH到ADPC组织,AR表达呈逐渐升高趋势,而GR表达呈逐渐降低趋势,当进展到AIPC时,AR表达明显降低,GR表达明显升高(P＜0.05).随着Gleason分级的增高,AR表达逐渐降低,GR表达逐渐升高(P＜0.05).结论 GR抑制了前列腺癌细胞的分化,长期雄激素阻断治疗导致AR表达降低,GR表达升高,AR/GR信号途径失衡是前列腺癌雄激素非依赖进展的重要原因.     

前列腺特异抗原临床意义的探讨

<正>前列腺特异抗原(t-PSA)在前列腺癌(PCa)患者的血清中可明显升高[1],但部分前列腺增生(BPH)患者血清t-PSA亦可以升高。文献[2,3]研究发现,血清中有少量的游离PSA(f-PSA),对区分BPH和PCa有意义。2007年3月至2008年8月检测了65名健康者,76例BPH患者和40例PCa患者的     

前列腺穿刺活检患者血清高敏C反应蛋白与Gleason评分的相关性

目的探讨前列腺癌(PCa)和前列腺增生(BPH)患者血清高敏C反应蛋白(hs-CRP)与Gleason评分的关系。方法分析261例经直肠前列腺穿刺活检患者病理诊断为PCa和BPH患者血清hs-CRP的差异,比较PCa患者hs-CRP增高和正常者高危性(Gleason评分≥7分)PCa患病率,运用Logistic回归分析hs-CRP、前列腺特异性抗原(tPSA)、前列腺特异性抗原密度(PSAD)、前列腺总体积(TPV)和年龄等因素对高危性PCa患病率的影响。结果 PCa患者血清hs-CRP的中位数为3.57mg/L,明显高于BPH患者的1.20mg/L(P<0.05)。在高危性PCa中hs-CRP为5.05mg/L,明显高于低危性PCa中的0.75mg/L(P<0.05)。PCa患者hs-CRP>3mg/L组高危性PCa患病率为94.23%(49/52),明显高于hs-CRP≤3mg/L组高危性PCa患病率59.45%(22/37)(P<0.05)。hs-CRP影响高危性PCa患病率的优势比(OR)为1.618(P<0.05)。结论 hs-CRP升高明显增加前列腺穿刺活检患者高危性PCa检出率;hs-CRP是影响高危性PCa患病率的独立因素。     

f-PSA/T-PSA在前列腺增生与前列腺癌鉴别诊断中的意义

目的:探讨血清中前列腺特异性抗原(t-PSA)、游离PSA(f-PSA)及f/t-PSA在前列腺增生(BPH)与前列腺癌(PCa)鉴别诊断中的意义。方法:应用放射免疫法检测90例BPH与PCa患者血清中的特异性抗原、游离PSA,并计算f/t-PSA比值。结果:血清PSA在4ng/mL~10ng/mL时,BPH与PCa组的特异性抗原含量差异无显著性(P>0.05),游离PSA、f/t-PSA比值差异有显著性(P<0.05)。结论:在BPH和PCa明显优于单纯使用特异性抗原,是早期诊断PCa的新参数,不但提高了PCa的检出率,也减少了不必要的前列腺穿刺活组织检查对患者造成的创伤和痛苦。     

前列腺特异性抗原在前列腺癌诊断中的应用

目的 研究两种形式前列腺特异性抗原:总前列腺特异性抗原(TPSA)、复合前列腺特异性抗原(cPSA)及其比值在前列腺癌诊断中的应用.方法 收集血清共190例,其中正常对照60例,前列腺癌为90例,前列腺增生为40例.Bayer化学发光法测得TPSA和CPSA,计算CPSA/TPSA比值.比较三组的CPSA、TPSA和CPSA/TPSA.结果 在正常对照、前列腺癌(PCa)、前列腺增生(BPH)血清中的浓度具有很好的一致性.PCa患者组的TPSA、CPSA浓度明显高于正常对照组(P＜0.001)和BPH患者组(P＜0.001),PCa患者组的CPSA/TPSA大于BPH患者组和正常对照组(P＜0.001)而BPH患者组和正常对照组CPSA/TPSA无统计学差异(P＞0.05).在相同的敏感度情况下,CPSA和CPSA/TPSA较TPSA显示出更高的特异性.结论 联合检测TPSA、CPSA及CPSA/TPSA,更有助于对前列腺癌的诊断.     

fPSA、TPSA及其比值在前列腺癌鉴别诊断中的应用评价

目的 观察血清总前列腺特异性抗原(TPSA)、游离前列腺特异性抗原(fPSA)及fPSA/TPSA比值在前列腺癌症鉴别诊断中的价值.方法 采用微粒子酶免疫技术,测量BPH和前列腺癌症患者的血清TPSA、fPSA,并计算f/T比值.结果 前列腺癌(PCa)组、前列腺增生(BPH)组与正常对照组差异有非常显著性(P＜0.01);在诊断灰区内(TPSA 4.0～20.0 μg/L)PCa组与BPH组TPSA、fPSA差异无显著性(P＞0.05),而f/T比值有明显差异(P＜0.01).结论 运用fPSA/TPSA比值,结合TPSA含量,可提高PCa与BPH鉴别诊断的特异性,对PCa的鉴别诊断疗效观察及高危人群的筛查等具有重要意义.     

F-PSA与T-PSA的比值对前列腺癌的诊断价值

目的探讨血清总前列腺特异性抗原(T-PSA)、游离前列腺特异性抗原(F-PSA)和F-PSA/T-PSA比值(F/T)对前列腺癌的诊断和临床意义。方法应用全自动化学发光分析仪检测健康对照组(60例),前列腺增生组(BPH组,49例)及前列腺癌组(PCa组,28例)血清T-PSA、F-PSA含量,计算F-PSA/T-PSA比值,分析T-PSA、F-PSA/T-PSA不同取值水平对临床诊断前列腺癌的灵敏度、特异性及诊断准确性的影响。结果 PCa组和BPH组的血清总前列腺特异性抗原、游离前列腺特异性抗原含量都比健康对照组高,差异具有统计学意义(P<0.05),PCa组的F-PSA、T-PSA含量高于BPH组,而F/T却比BPH组低许多,差异具有统计学意义(P<0.05)。结论 T-PSA界值取4 ng/ml,F/T取<0.16能有效地筛检前列腺癌,在鉴别前列腺癌与前列腺增生中有重要的临床应用价值。     

血清总PSA、游离PSA检测在前列腺癌诊断中的临床应用

目的：探讨血清T—PSA、F—PSA检测在前列腺癌（PCa）诊断中的应用价值。方法：运用酶联免疫方法检测28例前列腺癌患者、50例前列腺增生（BPH）患者和20例健康成年男性血清中T—PSA、F—PSA的情况并计算F／T比值。结果：①PCa组血清T—PSA、F—PSA的水平明显高于BPH组和正常对照组,差异有显著性意义（P〈0．01）。PCa组的F／T比值明显低于BPH组和正常对照组,差异有显著性意义（P〈0．01）。②PCa组血清T—PSA在4～10btg／L内的F／T比值与BPH的相同区间的指标相比,差异有显著性意义（P〈0．01）。PCa血清T—PSA≥10μg／L组的T—PSA水平与BPH的相同区间的指标相比．差异有显著性意义（P〈0．01）。⑧通过对F／T比值不同取值的结果进行比较发现取F／T比值〈0．16为界值时诊断PCa和BPH的灵敏性分别为85．71％和28．00％,特异性为85．00％和75．00％,F／T和T—PSA对PCa诊断效率分别为85．42％、68．57％。结论：血清T—PSA用于筛选诊断PCa和鉴别诊断BPH的作用十分明确,同时以F—PSA和F／T比值作为辅助性指标鉴别血清T—PSA水平在4～10μg／L的PCa和BPH可以弥补T—PSA的不足。     

前列腺特异抗原在前列腺疾病诊断中的应用

目的 探讨血清中总前列腺特异抗原(T-PSA)、游离前列腺特异抗原(F-PSA)与F/T PSA比值在前列腺疾病诊断中的作用.方法 采用电化学发光免疫分析法(ECLI)检测70例前列腺增生(BPH)症患者、26例慢性前列腺炎患者和28例前列腺癌(PCa)患者血清中的T-PSA、F-PSA,并计算F/T PSA比值.结果 3组患者之间的T-PSA差异有统计学意义(P<0.01),BPH症患者的F/T PSA比值与前列腺癌(PCa)患者差异有统计学意义(P<0.01),与慢性前列腺炎患者差异无统计学意义(P>0.05);当T-PSA在4.0～10g/L时,三组患者的T-PSA差异无统计学意义(P>0.05),而BPH症患者的F/T PSA与前列腺癌(PCa)患者差异存在统计学意义(P<0.01),与慢性前列腺炎患者差异无统计学意义(P>0.05).结论 4 g/L相似文献   

神经降压素在雄激素非依赖性前列腺肿瘤动物模型中的表达

【摘要】目的观察神经降压素（NT）在原位前列腺肿瘤动物模型中的表达。方法利用原位种植包埋法和外科手术去势技术对Balbc-nu裸鼠分别构建雄激素依赖、去势3d和雄激素非依赖性原位前列腺肿瘤动物模型;Af? fymetrix基因芯片技术检测NT在3组肿瘤组织中mRNA的表达差异,运用荧光实时定量聚合酶链反应（qRT-PCR）验证结果;HE染色在光镜下观察肿瘤组织病理学改变;ELISA法测定裸鼠血清前列腺特异性抗原（PSA）浓度;免疫组织化学法检测3组肿瘤组织中NT的蛋白相对表达量。结果与雄激素依赖组比较,雄激素非依赖组和去势3d 组NTmRNA表达分别上调5.10和下调0.33;用RT-PCR和qRT-PCR验证其结果,雄激素非依赖组的表达水平较雄激素依赖组分别上调1.41和7.27（P＜0.01）,去势3d组的表达水平分别下调0.78和0.46（P＜0.05）;肿瘤组织HE 染色可见明显的核异型性和瘤节结构;雄激素依赖组PSA和NT结果均分别为（0.48±0.03）μg/L和0.031±0.008,去势3d组均分别为（0.17±0.03）μg/L和0.021±0.004,雄激素非依赖组均分别为（0.87±0.02）μg/L和0.042±0.010;与雄激素依赖组比较,去势3d组表达降低,雄激素非依赖组表达升高（P＜0.01）。结论NT在前列腺肿瘤由雄激素依赖向雄激素非依赖这一变化过程中起着一定的作用,可以作为雄激素非依赖性前列腺肿瘤治疗靶点和特异性诊断指标。     

多西紫杉醇联合强的松治疗激素难治性前列腺癌的疗效

目的探讨多西紫杉醇联合强的松治疗激素难治性前列腺癌的临床疗效。方法 64例激素难治性前列腺癌患者随机分为治疗组(32例)和对照组(32例)。两组均每3周(1个治疗周期)用多西紫杉醇75mg/m2静脉滴注1h。治疗组加用强的松5mg,每天2次。比较疗效及不良反应。结果 64例中,5例完成了8个周期治疗,15例6个周期,42例4个周期,2例1个周期。治疗组化疗后总有效率为87.5%,明显高于对照组的56.2%(P<0.05)。治疗组疼痛减轻效果也优于对照组。两组不良反应相仿(P>0.05)。结论多西紫杉醇联合强的松治疗激素难治性前列腺癌疗效确切,明显改善患者生活质量。     

Biological behavior of prostate cancer cells in 3D culture systems

Prostate cancer is the most common non-cutaneous malignant neoplasm in men in Western countries. In Japan, the number of afflicted men has been increasing although it is still low compared with Western countries. One of the most important problems in prostate cancer patients is treatment for hormone-refractory prostate cancer (HRPC). Although docetaxel is considered as a first-line chemotherapeutic option in patients with HRPC in the USA, it is still necessary to search and develop new drugs. Spheroid culture models have an invaluable role in tumor biology or drug screening. Characteristics of cancer cells in three-dimensional (3D) culture, especially spheroid culture, differ dramatically from those in two-dimensional (2D) culture. Spheroid culture models appear to be an ideal tool, however, their models have not been incorporated in drug screening. In this article, we demonstrate characterization of prostate cancer spheroids including chemo-resistance compared with 2D culture and xenograft models. Prostate cancer cells except PC-3 formed E-cadherin-mediated spheroids. An immunocytochemical analysis of the spheroids revealed that cells showing Ki-67 were localized in the peripheral layer and the intermediate zone cells showed p27 and poly (ADP-ribose) polymerase-1 (PARP-1), suggesting quiescent cell character. Prostate cancer cells acquired resistance to most agents when grown as spheroids, but not to all of the anticancer agents tested. This article also attempts to provide up-to-date information about spheroids, especially quiescent cells as therapeutic targets and the involvement of genetics and epigenetics in forming spheroids.     

Doxil (Caelyx): an exploratory study with pharmacokinetics in patients with hormone-refractory prostate cancer

Doxil, a doxorubicin formulation of polyethylene glycol-coated liposomes, has anti-tumor activity against Kaposi's sarcoma and other solid tumors with mild myelosuppression, minimal hair loss and a low risk of cardiotoxicity. Non-liposomal doxorubicin has modest activity in hormone-refractory prostate cancer (HRPC) with considerable toxicity. A pilot study of Doxil was conducted in 15 patients with HRPC. Doxil was administered i.v. using two regimes of equal dose intensity, either 45 mg/m2 every 3 weeks or 60 mg/m2 every 4 weeks. Plasma levels of doxorubicin were analyzed in 10 patients. The most common side effect was stomatitis with a higher incidence at the 60 mg/m2 dose level. In contrast, hand-foot syndrome was more frequent and severe in patients treated with the 3 week schedule of 45 mg/m2. Three patients responded to treatment (based on objective response in one patient and reduction of PSA level greater than 50% in the other two) and two patients had stable disease, all of them receiving 60 mg/m2. Pharmacokinetic analysis shows a proportional increase of plasma drug levels with dose and the characteristic long circulation time of Doxil with half-lives in the range of 3 days, somewhat longer than previously reported. In conclusion, Doxil at 60 mg/m2 every 4 weeks appears to be active against HRPC, but severe mucocutaneous toxicities prevented further investigation of this regime.     

Hormone refractory prostate cancer (HRPC): present and future approaches of therapy

The mainstay of therapy for patients with advanced prostate cancer still remains androgen deprivation, although response to this is invariably temporary. Most of the patients develop hormone-refractory disease resulting in progressive clinical deterioration and, ultimately, death. Until recently there has been no standard chemotherapeutic approach for hormone refractory prostate cancer (HRPC), the major benefits of chemotherapy being only palliative. The studies combining mitoxantrone plus a corticosteroid demonstrated that chemotherapy could be given to men with symptomatic HRPC with minimal toxicity and a significant palliation could be provided. Recently, results from 2 phase III randomized clinical trials demonstrating that a combination of docetaxel plus prednisone can improve survival in men with HRPC have propelled docetaxel-based therapy into the forefront of treatment options for these patients as the new standard of care. There is a promising activity of new drug combinations such as taxanes plus vinca alkaloids; bisphosphonates are assuming a prominent role in prostate therapy through their ability to prevent skeletal morbidity. Combinations of classic chemotherapeutic agents and biological drugs began to be tested in phase II-III trials and the first results appear interesting. This article focuses on combinations recently evaluated or under clinical development for the treatment of HRPC.     

Hormone-refractory prostate cancer: where are we going?

This article addresses the current status of therapeutic options in the management of hormone-refractory prostate cancer (HRPC). Following the publication of two landmark randomised trials, docetaxel chemotherapy is now the standard of care for men with metastatic HRPC. However, the benefit of this treatment is limited. Trials are now focusing on improving the efficacy of docetaxel by combining it with novel biological agents. Several new docetaxel-based combinations are under evaluation and promising results have been found for the combination of docetaxel with angiogenesis inhibitors. Early phase III trial data for atrasentan appear interesting. New cytotoxic agents such as satraplatin and ixabepilone are being investigated in several ongoing studies in order to define their role as second-line treatments of HRPC. Vaccine therapy offers an active immunological approach for combating malignancy in a targeted manner.     

Clinical significance of a prostate-specific antigen flare phenomenon in patients with hormone-refractory prostate cancer receiving docetaxel

Docetaxel has shown promise for the treatment of hormone-refractory prostate cancer and has become the standard of care. The flare phenomenon is a known entity in androgen-deprivation therapy of advanced prostate cancer and it has also been described in palliative chemotherapy of hormone-refractory prostate cancer. The aim of this study was to evaluate the clinical impact of a prostate-specific antigen flare phenomenon in docetaxel-treated hormone-refractory prostate cancer patients. From December 2002 to August 2005, we treated 44 patients with hormone-refractory prostate cancer applying docetaxel-based regimens. Prostate-specific antigen levels were determined before therapy and weekly thereafter. Patients were divided into three groups: response (group 1), progression (group 2) and flare (group 3). Flare was defined as initially rising prostate-specific antigen under therapy, dropping thereafter to values below baseline. The groups were compared for overall survival by Kaplan-Meier analysis. We observed a prostate-specific antigen flare phenomenon in eight (18%) of 44 evaluable patients; 24 (54.5%) patients were primary responders and 12 (27.3%) experienced progressive disease. In group 3, prostate-specific antigen levels rose to 107-180% from baseline and then dropped to 21-68%. Kaplan-Meier analysis showed significantly better overall median survival for groups 1 (18 months, P=0.0005) and 3 (19 months, P=0.006) than for group 2 (7 months). Survival in groups 1 and 3 was comparable. Grade 3 and 4 toxicity was below 5% and equally distributed between the 3 groups. In our limited patient cohort, prostate-specific antigen flare phenomenon does not seem to be a clinically relevant issue in terms of overall survival. Thus, an initial rise of prostate-specific antigen under docetaxel therapy in hormone-refractory prostate cancer does not indicate therapeutic failure and should not lead to early withdrawal from therapy in the absence of clinical signs of progression.     

前列腺疾病患者血清TPSA、FPSA和PAP的检测及其意义

为探讨总前列腺特异性抗原 (TPSA)、游离前列腺特异性抗原 (FPSA)、前列腺酸性磷酸酶 (PAP)的检测对前列腺疾病的诊断价值 ,采用双抗体夹心酶联免疫 (ELISA)法对 3 8例前列腺癌、85例前列腺良性疾病和 40例正常人血清中 TPSA、FPSA和PAP水平进行了检测。结果显示 ,前列腺癌患者血清中 TPSA、 FPSA和 PAP水平均显著高于前列腺良性疾病组和正常对照组 (P<0 .0 1) ,F/ T比值前列腺癌组明显低于前列腺良性疾病组和正常组 (P<0 .0 1) ,前列腺良性疾病组与正常组无明显差别。     

核糖体蛋白L6 在前列腺癌中的表达及临床意义

摘要:目的 探讨核糖体蛋白 L6 （RPL6） 在前列腺癌组织中的表达及临床意义。方法 应用实时荧光定量 PCR （RT-qPCR） 和 Western blot 检测 RPL6 在前列腺癌组织 （80 例） 及癌旁组织 （62 例） 中的表达水平, 分析 RPL6 mRNA 表达水平与前列腺癌患者的临床病理特征及预后之间的关系。结果 RPL6 在前列腺癌组织中的表达水平明显高于癌旁组织(P < 0.05); 血清前列腺特异性抗原 （PSA） 值高、 Gleason 评分高、 临床分期晚、 有淋巴结转移患者的 RPL6 mRNA 表达水平增高 （均 P < 0.05）, 而不同年龄、 精囊侵袭、 血管侵犯及手术切缘阳性情况患者的 RPL6 mRNA 表达水平无明显差异(均 P > 0.05)。 RPL6 mRNA 高表达前列腺癌患者的术后无生化复发生存率较低 （χ2 =4.530,P= 0.033）。结论 RPL6 表达水平增高与前列腺癌的发生发展及不良预后相关; 或可用其作为初步判断前列腺癌患者预后的肿瘤标志物。     

氟他胺加睾丸切除治疗晚期前列腺癌22 例

目的观察三七总皂甙联合氟他胺治疗前列腺癌的临床疗效。方法将60例前列腺癌患者分为对照组和实验组,对照组22例,给予氟他胺250mg,3次/天;治疗组38例,在对照组基础上给予静脉滴注三七总皂苷注射液2mL,每日1次,治疗两个月后通过比较两组患者治疗前后前列腺体积、排尿困难的情况、血清f/tPSA水平的变化及两组的治疗疗效。结果两组患者治疗前前列腺的体积,排尿困难的情况、血清f/tPSA水平均无显著性差异;治疗后两组患者前列腺的体积均显著小于治疗前,排尿困难的发生率较治疗前均显著降低,血清f/tPSA水平均显著高于治疗前;且治疗后实验组患者前列腺的体积小于对照组,排尿困难的发生率低于对照组,血清f/tPSA水平高于对照组。实验组治疗的总有效率为84.21%,显著高于对照组(72.72%)(P<0.05)。结论三七总皂甙联合氟他胺治疗前列腺癌的临床疗效优于单用氟他胺,可进一步研究和推广。