前列腺癌的分子病理学研究进展

病理学分级及临床分期对前列腺癌的预后评价存在一定的局限性。近年来,随着对前列腺癌分子病理学研究的深入,凋亡相关基因和肿瘤抑制基因在前列腺癌发生发展中的作用及其预测价值受到普遍关注。bcl—2的过表达出现于高度恶性的前列腺癌患者中,且与雄激素抗性和抗癌药物的耐药性有关。肿瘤抑制基因p53的突变见于前列腺上皮内瘤(prostatic intraepithelial neop1asia,PIN)和前列腺癌中,p53蛋白可作为前列腺癌的独立预后指标。PTEN和p27的丢失是前列腺癌重要的阴性预测因子。p21和p16的过表达对前列腺癌的形成和分化均有影响。Fas／FasL,系统在调控前列腺上皮细胞的凋亡起着重要作用,参与前列腺癌的发生。近来发现的BRCAl及p73基因在前列腺癌的发生发展中亦起一定作用。

Recent advances on molecular pathology of prostate carcinoma

The pathologic grade and clinical stage have some restrictions for the evaluation of the prognosis of prostate carcinoma. Recently, the function of genes related to apoptosis and tumor suppressor genes on the development, progression,and prognostic value of prostate carcinoma was paid close attention due to further research on the molecular pathology of prostate cancer. Overexpression of Bcl 2 was found in high malignant patients of prostate carcinoma and related to androgen refraction and resistance against anticancer agents as well. The mutation of p53 was found in prostatic intraepithelial neoplasia(PIN) and prostate cancer. p53 can be used as an independent prognostic factor for prostate cancer. The deletion of PTEN and p27 is an important negative factor of prognosis. Overexpression of p21 and p16 which are inhibition protein of cell cycle have effects on the formation and differentiation of prostate cancer. Fas/FasL system plays an important role in apoptosis of prostatic epithelial cells and takes part in the carcinogenesis of prostate. BRCA1 and p73 also have effects on the genesis and development of prostate cancer.