TMPRSS2-ERG融合基因与转移性去势抵抗性前列腺癌化学药物治疗后生存率的关系

目的 明确TMPRSS2-ERG（T-E）融合基因与转移性去势抵抗性前列腺癌（metastatic castration-resistant prostate cancer，mCRPC）多西他赛化学药物治疗（以下简称化疗）后生存率的关系。方法 选取首都医科大学附属北京同仁医院前列腺增生患者20例，前列腺癌化疗的患者50例。用实时定量聚合酶链反应（quantitative real time polymerase chain reaction，qRT-PCR）检查患者外周血单核细胞中融合基因表达。通过前列腺特异性抗原（prostate specific antigen，PSA）应答率、PSA-无进展生存率（free survival，PSA-PFS）、放射学无进展生存率（radiological progression free survival，RX-PFS）和总生存率（overall survival，OS）评估不同融合基因表达患者的治疗反应。结果 50例前列腺癌患者中10例（20%）检测到T-E融合基因。T-E阳性组的PSA应答率低于阴性组（32.52%vs 74.35%，P=0.040）。单因素生存分析显示T-E阳性患者前列腺PSA-PFS、RX-PFS、OS低于阴性患者，差异均有统计学意义（P < 0.01）。多因素Cox回归分析显示T-E阳性是PSA-PFS、RX-PFS和OS的独立危险因素（P=0.010，P=0.010，P=0.020）。结论 T-E融合基因表达是多西他赛化疗mCRPC患者PSA-PFS、RX-PFS和OS的独立危险因素。

Correlation between TMPRSS2-ERG fusion gene and survival rate of metastatic castration-resistant prostate cancer after chemotherapy

Objective To determine the correlation of TMPRSS2-ERG(T-E) fusion gene to the survival rate in metastatic castration-resistant prostate cancer after docetaxel chemotherapy. Methods We included 20 patients with benign prostatic hyperplasia and 50 patients with prostate cancer(mCRPC) chemotherapy. The expression of T-E fusion gene in peripheral blood mononuclear cells was examined by quantitative real time polymerase chain reaction(qRT-PCR). Therapeutic responses of patients with different fusion gene expression were assessed by prostate specific antigen (PSA) response rate, PSA-progression free survival(PFS), radiological progression free survival(RX-PFS), and overall survival(OS). Results The T-E fusion gene was detected in 10 (20%) of 50 prostate cancer patients. The PSA response rate in the T-E positive group was lower than that in the negative group (32.52% vs 74.35%, P=0.040). Univariate survival analysis showed that PSA-PFS, RX-PFS, and OS were lower in T-E positive patients than in negative patients, and the difference was statistically significant (P<0.01). Multivariate Cox regression analysis showed that T-E positive was an independent risk factor for PSA-PFS, RX-PFS and OS (P=0.010, P=0.010, P=0.020). Conclusion This study demonstrates that T-E fusion gene expression is an independent risk factor for PSA-PFS, RX-PFS and OS in mCRPC patients treated with docetaxel.