Analysis of distribution of dihydrotestosterone concentration in prostate cancer tissue and differences of dihydrotestosterone and androgen induced gene expression after androgen deprivation

目的：分子研究表明种族影响前列腺癌生物学。我们使用组织芯片(TMA)对日本患者的局限性前列腺癌的多个已知预后标志物进行了评估。方法：样本来自1997年至2001年在我所接受根治性手术的52名患者，这些患者没有接受新辅助激素治疗，且有3个或更多可用癌点。检测Ki67、P53和雄激素受体(AR)抗原的表达。结果：病理肿瘤(T)分类(p=0.047)、世界卫生组织评分(p=0.026)、世界卫生组织组织分级(p=0.026)和手术切缘状况(p=0.018)是预测生化失败的重要临床病理变量。TMA Gleason sum(p=0.038)、TMA原发Gleason分级(p=0.013)、Ki67标记指数(LI)(p&lt；0.0001)、P53(p=0.0097)和AR(p=0.0113)抗原表达也具有统计学意义。此外，手术切缘状况和Ki67 LI与治疗失败独立相关。结论：特别是在日本局部前列腺癌中，Ki67 LI、P53和AR的表达共同预测了手术后的进展。

Objectives : Molecular studies suggest that ethnicity influences prostate tumor biology. We evaluated multiple known prognostic markers in localized prostate cancers using tissue microarrays (TMA) in Japanese patients.Methods : Specimens were from 52 patients undergoing radical surgery at our institution between 1997 and 2001 without neoadjuvant hormonal therapy with complete 3 or more available cancer spots. Ki67, p53, and androgen receptor(AR) antigen expression were examined. Immunohistochemical scores were compared with outcomes of chemical relapse as monitored using prostate-specific antigen(PSA).Results : Pathologic tumor (T) classification (p=0.047), World Health Organization(WHO) score (p=0.026), WHO histologic grade (p=0.026), and surgical margin status (p=0.018) were significant conventional clinicopathologic variables for predicting biochemical failure. TMA Gleason sum (p=0.038), TMA primary Gleason grade (p=0.013), Ki67 labeling index (LI) (p<0.0001), p53 (p=0.0097), and AR (p=0.0113) antigen expression also were significant. Moreover, surgical margin status and Ki67 LI were independently associated with treatment failure.Conclusions : Especially together, Ki67 LI and p53 and AR expression in a localized prostate cancer often predicted postoperative progression in Japanese patients.