摘要
目的通过前瞻性队列研究,探讨ETS相关基因(ETS-related gene,ERG)扩增水平作为前列腺癌根治术患者预后预测指标的价值。方法通过荧光原位杂交的方法检测前列腺癌根治术患者组织样本中的ERG扩增水平,与患者的血清PSA水平、病理Gleason评分、病理分期、Ki-67表达水平进行相关性分析,并对患者的生化复发情况进行预测。结果前瞻性队列共纳入152例接受前列腺癌根治术的患者,其中有53例的组织标本为ERG阳性(34.9%)。ERG扩增水平与病理Gleason评分(P<0.05)和Ki-67表达水平(P<0.05)显著相关。ERG阳性率在Gleason评分6分、7分和>7分组中分别为59%、39%和14%,而在Ki-67阳性比例<2%、2%~10%和>10%组中分别为46%、26%和22%。此外,ERG扩增阳性在低血清PSA(P=0.256)和低病理T分期(P=0.200)的患者中更常见,但差异无统计学意义。Cox回归分析发现ERG阴性(HR=0.42,95%CI:0.17~1.03)和Ki-67高表达(HR=1.00,95%CI:0.96~1.02)均是前列腺癌根治术后患者生化复发的独立危险因素。根据Kaplan-Meier生存分析证实ERG阴性同时Ki-67高表达组的患者无生化复发生存时间最短,其次是ERG阴性同时Ki-67低表达组(P=0.058)和ERG阳性同时Ki-67低表达组(P<0.01),而ERG阳性同时Ki-67高表达组(P<0.001)的无疾病进展生存时间最长。结论在ERG整体阳性比例较低的人群中,ERG扩增水平是前列腺癌根治术后患者生化复发的独立预后因素。ERG与Ki-67等其他生物标志物的联合应用具有更理想的预测效能。
Objective To prospectively investigate the value of ETS-related gene(ERG)as a prognostic factor in patients undergoing radical prostatectomy.Methods The amplification level of ERG in tissue samples of patients undergoing radical prostatectomy was detected by fluorescence in situ hybridization.The correlation between ERG amplification level and serum PSA level,Gleason score,pathological stage and Ki-67 expression level were analyzed,and the predictive value for biochemical recurrence was estimated.Results A total of 152 patients who underwent radical prostatectomy were included,of which ERG was positive in 53 prostate cancer samples(34.9%).ERG was significantly associated with postoperative Gleason score(P<0.05)and Ki-67 positive percentage(P<0.05).The positive rate of ERG was significantly higher in patients with Gleason score=6(59%),compared with those having Gleason score=7(39%)or Gleason score>7(14%).The positive rate of ERG was significantly higher in patients with Ki-67 positive percentage<2%(46%),compared with those having Ki-67 positive percentage 2%-10%(26%)and>10%(22%).Furthermore,positive expression of ERG occurred more frequently in patients with lower PSA(P=0.256)and lower pathological T stage(P=0.200),but without statistically significant.Cox regression analysis showed that both ERG negative(HR=0.42,95%CI:0.17-1.03)and high Ki-67 expression(HR=1.00,95%CI:0.96-1.02)were independent risk factors for biochemical recurrence in patients after radical prostatectomy.Kaplan-Meier survival analysis confirmed that the subset of patients with negative ERG and high Ki-67 had the significant shorter biochemical recurrence-free survival compared to those with positive ERG and high Ki-67(P<0.001)or those with positive ERG and low Ki-67(P<0.01),while marginally shorter survival compared to those with negative ERG and low Ki-67(P=0.058).Conclusion Among the population with a low prevalence of ERG positive,ERG status is an independent prognostic factor for survival outcomes in patients undergoing radical prostatectomy
作者
吴涵
庞庆阳
花梅免
柳文强
杨懿人
施晓磊
张威
WU Han;PANG Qingyang;HUA Meimian;LIU Wenqiang;YANG Yiren;SHI Xiaolei;ZHANG Wei(Department of Urology,Changhai Hospital,the First Affiliated Hospital of Naval Medical University,Shanghai,200433,China)
出处
《临床泌尿外科杂志》
CAS
2023年第8期589-595,共7页
Journal of Clinical Urology
基金
海军军医大学启航人才项目(2021)
长海医院基础医学研究专项(No:2021JCMS04)
国家自然科学基金青年项目(No:81802581)。
