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目的研究前列腺癌神经内分泌分化(neuroendocrine differentiation,NED)及Ki-67与前列腺癌预后的关系。方法收集有完整临床和随访资料的40例前列腺癌手术切除标本,应用免疫组化Polymer conjugate法检测嗜铬素A(CgA)、神经特异性烯醇化酶(NSE)、突触素(SYN)及增殖指标Ki-67表达情况,同时分析NED与增殖指标Ki-67及Gleason积分的关系。单因素Cox风险模型分析前列腺癌NED与患者术后生存的关系。结果40例前列腺癌患者中有11例伴有神经内分泌分化(27.5%),且这组患者的3年生存率明显低于同时期不伴有神经内分泌分化的前列腺癌组(P<0.05)。前列腺癌伴NED患者中Ki-67表达水平与不伴有NED的前列腺癌患者比较差异有统计学意义(P<0.05),且NED表达水平与Gleason积分成正相关。单因素Cox回归分析显示前列腺癌术后生存时间与Gleason积分(P<0.05)、NED阳性密切相关(P<0.05)。结论前列腺癌NED与患者术后生存有关,联合检测前列腺癌NED与Ki-67的表达可能能更好地判断前列腺癌的预后。
Objective To study the relationship between the neuroendocrine differentiation (NED) and Ki-67 in prostate cancer and the prognosis of prostate cancer. Methods 40 cases of prostate cancer resected specimens with complete clinical and follow-up data were collected. The immunohistochemical Polymer conjugate method was used to detect the levels of CgA, NSE, SYN and Proliferation index Ki-67 expression, at the same time analyze the relationship between NED and proliferation index Ki-67 and Gleason integral. Relationship between NED in prostate cancer and postoperative survival of patients with univariate Cox risk model. Results Of the 40 patients with prostate cancer, 11 had neuroendocrine differentiation (27.5%), and the 3-year survival rate of this group was significantly lower than that of the prostate cancer group without neuroendocrine differentiation in the same period (P <0.05). The expression of Ki-67 in patients with prostate cancer with NED was significantly lower than those without prostate cancer (P <0.05), and the expression of NED was positively correlated with Gleason score. Univariate Cox regression analysis showed that postoperative survival time of prostate cancer was closely related to Gleason score (P <0.05) and NED (P <0.05). Conclusions The NED of prostate cancer is related to the postoperative survival of patients. Combined detection of NED and Ki-67 expression in prostate cancer may be a better way to judge the prognosis of prostate cancer.