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目的检测中国前列腺癌患者ETS相关基因(ERG)重排及蛋白表达情况,分析其与患者预后的关系。方法选取四川大学华西医院2009~2014年前列腺穿刺确诊的前列腺癌患者482例,采用荧光原位杂交法检测ERG基因重排情况,采用免疫组化染色法检测ERG蛋白表达情况。采用Spearman秩相关分析ERG基因重排与蛋白表达的相关性,采用χ~2检验分析ERG基因重排和蛋白表达与患者临床病理特征的关系,采用KaplanMeier法分析ERG基因重排和蛋白表达与患者预后的关系。结果 87例(18.0%)患者检出ERG基因重排,其中45例(51.7%)为转位重排,42例(48.3%)为缺失重排。74例(15.4%)患者表达ERG蛋白。ERG蛋白表达与基因重排正相关(r=0.849,P=0.000)。368例获得随访资料,ERG基因重排状态及蛋白表达水平与患者年龄、Gleason评分、初诊时前列腺特异性抗原(PSA)水平无关(P>0.05),但发生远处转移及进展为去势抵抗性前列腺癌(CRPC)的病例中ERG蛋白表达率下降(P<0.05)。预后分析显示ERG基因重排及蛋白表达均不能提示预后。结论 ERG基因重排状态与蛋白表达情况均不能作为前列腺癌进展为CRPC及总生存率的独立预测指标。
Objective To detect the gene rearrangement and protein expression of ETS related genes (ERG) in Chinese patients with prostate cancer and analyze its relationship with the prognosis of patients. Methods 482 prostate cancer patients diagnosed by prostate biopsy from 2009 to 2014 in West China Hospital of Sichuan University were selected. ERG gene rearrangement was detected by fluorescence in situ hybridization. The expression of ERG protein was detected by immunohistochemistry. The relationship between ERG gene rearrangement and protein expression was analyzed by Spearman rank correlation. The relationship between ERG gene rearrangement and protein expression and clinicopathological features was analyzed by Chi-square test. The Kaplan Meier method was used to analyze the relationship between ERG gene rearrangement and protein expression Prognosis of the relationship. Results ERG gene rearrangements were detected in 87 patients (18.0%), of which 45 (51.7%) were translocation rearrangements and 42 (48.3%) were deletion rearrangements. 74 (15.4%) patients expressed ERG protein. ERG protein expression was positively correlated with gene rearrangement (r = 0.849, P = 0.000). 368 cases were followed up, ERG gene rearrangement status and protein expression level and age of patients, Gleason score, prostate specific antigen (PSA) level had no correlation (P> 0.05), but the occurrence of distant metastasis and progression of castrate resistance ERG protein expression was decreased in cases of prostate cancer (CRPC) (P <0.05). Prognostic analysis showed that ERG gene rearrangement and protein expression can not prompt the prognosis. Conclusion The status of ERG gene rearrangement and protein expression can not be used as an independent predictor of progression of prostate cancer to CRPC and overall survival.