雄激素受体剪接变异体7与雄激素受体比值预测前列腺癌预后的意义分析

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目的:探讨雄激素受体剪接变异体7(AR-V7)与雄激素受体(AR)比值(AR-V7/AR)对前列腺癌预后的预测价值。方法:选择2013年3月至2018年3月广东省高州市人民医院收治的105例接受内分泌初治的前列腺癌患者,以免疫组织化学法检测活检穿刺标本的AR、AR-V7表达情况,分析AR、AR-V7、AR-V7/AR与患者预后的关系,并对影响前列腺癌预后相关因素采用Cox模型进行分析。结果:AR阳性率为59.0%(62/105),AR-V7阳性率为19.0%(20/105)。随访15~61(44.8 ± 10.1)个月,AR-V7阳性者的无进展生存时间(PFS)以及总生存时间(OS)均较阴性者明显缩短[(10.8 ± 2.2)个月比(25.0 ± 3.4)个月、(20.3 ± 5.1)个月比(42.8 ± 7.4)个月],差异有统计学意义(n P<0.01),而高AR-V7/AR者的PFS以及OS较低AR-V7/AR者亦明显缩短[(12.5 ± 3.2)个月比(24.9 ± 5.5)个月、(22.5 ± 4.6)个月比(42.1 ± 8.3)个月],差异有统计学意义(n P<0.01)。Cox多因素分析提示Tn 4期(n HR = 2.618,95% n CI 1.362 ~ 4.986,n P<0.01)、高AR-V7/AR(n HR = 5.799,95% n CI 2.541 ~ 13.253,n P<0.01)可作为影响前列腺癌不良预后的独立危险因素。n 结论:接受内分泌初治的前列腺癌患者如AR-V7阳性、高AR-V7/AR时则PFS、OS可缩短,高AR-V7/AR可成为评估该类患者预后不良的相关危险因素。“,”Objective:To evaluate the prognostic value of the ratio of androgen receptor splice variant 7 (AR-V7) and androgen receptor (AR) in prostate cancer.Methods:One hundred and five prostate cancer patients treated by castration therapy were selected in this study in People′s Hospital of Gaozhou City, Guangdong Province from March 2013 to March 2018. The expression of AR and AR-V7 in biopsy specimens was detected by immunohistochemistry. The relationship between AR, AR-V7, AR-V7/AR and prognosis of patients was analyzed. Cox regression was used to analyze the related factors affecting prognosis of prostate cancer.Results:The positive rate of AR expression was 59.0% (62/105), and the positive rate of AR-V7 expression was 19.0% (20/105). The patients were followed up for 15 to 61 (44.8 ± 10.1) months. The progression free survival (PFS) and overall survival (OS) in AR-V7 positive patients were significantly shorter than those in AR-V7 negative patients: (10.8 ± 2.2) months vs. (25.0 ± 3.4) months and (20.3 ± 5.1) months vs. (42.8 ± 7.4) months, and there were statistical differences (n P<0.01). The PFS and OS in high AR-V7/AR expression patients were significantly shorter than those in low AR-V7/AR expression patients: (12.5 ± 3.2) months vs. (24.9 ± 5.5) months and (22.5 ± 4.6) months vs. (42.1 ± 8.3) months, and there were statistical differences (n P<0.01). In multivariate Cox regression analyses, T4 stage (HR = 2.618, 95% CI 1.362 to 4.986,n P<0.01) and high AR-V7/AR (n HR = 5.799, 95% n CI 2.541 to 13.253, n P<0.01) could effectively and independently predict the prognosis of hormonal therapy.n Conclusions:AR-V7 positive and high AR-V7/AR prostate cancer patients treated by castration therapy may have shorter PFS and OS, compared with AR-V7 negative and low AR-V7/AR patients. High AR-V7/AR is the independent predictor of the prognosis of prostate cancer.
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