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目的探讨短期新辅助内分泌治疗(NHT)前后前列腺癌组织MUC1表达水平的变化及其临床意义。方法2004年1月至2011年1月21例前列腺癌患者纳入本研究,患者经B超引导下行前列腺穿刺活检病理检查确诊为前列腺癌后先行NHT 3~9个月,然后行前列腺癌根治性切除术。NHT采用促性腺激素释放激素激动剂联合抗雄激素药物的最大雄激素阻断治疗。取NHT前穿刺活检标本及NHT后的前列腺癌根治性切除术后大体标本采用免疫组织化学方法检测前列腺癌组织内MUC1表达水平;检测血清总前列腺特异抗原(t PSA)水平;前列腺癌组织分级采用Gleason评分系统;NHT后MUC1表达与血清t PSA水平及Gleason评分的相关性采用Spearman’s相关分析。结果 NHT治疗前癌组织中MUC1表达弱阳性,染色强度为(1.52±0.59);NHT治疗后MUC1表达增强,染色强度为(2.27±0.88),NHT后MUC1表达高于NHT前,差异有统计学意义(P<0.05);治疗前后前列腺癌Gleason评分分别为(6.5±0.3)、(6.1±0.8),差异无统计学意义(P>0.05);NHT治疗前后血t PSA水平分别为(80.81±22.26)ng/ml、(4.11±1.72)ng/ml,差异有统计学意义(P<0.01)。NHT治疗后前列腺癌组织中MUC1表达与前列腺癌Gleason评分无相关性(r=0.075,P>0.05),与血清t PSA水平呈正相关(r=0.507,P<0.05)。结论短期NHT可使前列腺癌细胞内MUC1表达上调,针对MUC1的辅助治疗有可能提高短期NHT的效果。
Objective To investigate the changes of MUC1 expression in prostate cancer tissues before and after short-term neoadjuvant endocrine therapy (NHT) and its clinical significance. Methods Twenty-one patients with prostate cancer from January 2004 to January 2011 were enrolled in this study. Patients underwent B-guided prostatic biopsy to diagnose prostate cancer, followed by NHT for 3 to 9 months, followed by radical resection of prostate cancer Surgery. NHT uses gonadotropin-releasing hormone agonist in combination with anti-androgen drugs maximal androgen blockade therapy. Pre-NHT biopsy specimens and NHT after radical prostatectomy specimens were used immunohistochemistry to detect the expression of MUC1 in prostate cancer tissue; serum total prostate-specific antigen (t PSA) levels; prostate cancer tissue grading Gleason scoring system. The correlation between MUC1 expression and serum t PSA level and Gleason score after NHT was analyzed by Spearman’s correlation analysis. Results The expression of MUC1 was weakly positive in NHT before treatment (1.52 ± 0.59). The expression of MUC1 was enhanced after treatment with NHT (2.27 ± 0.88), and the expression of MUC1 in NHT was higher than that before NHT (P <0.05). The Gleason score of prostate cancer before and after treatment were (6.5 ± 0.3) and (6.1 ± 0.8) respectively, with no significant difference (P> 0.05). The serum levels of t PSA before and after treatment were (80.81 ± 22.26) ng / ml, (4.11 ± 1.72) ng / ml, the difference was statistically significant (P <0.01). There was no correlation between the expression of MUC1 and the Gleason score of prostate cancer (r = 0.075, P> 0.05). The expression of MUC1 was positively correlated with the level of serum t PSA in patients with NHT (r = 0.507, P <0.05). Conclusions Short-term NHT can up-regulate the expression of MUC1 in prostate cancer cells, and adjuvant therapy with MUC1 may improve the effect of short-term NHT.