TGF-β1、VEGF在前列腺癌临床分期及冷冻治疗前后表达的临床意义

发布时间：2018-05-25 15:38

  本文选题：前列腺癌 + TGF-β1　； 参考：《天津医科大学》2014年硕士论文

【摘要】：目的 前列腺癌(Prostate cancer, PCa)是男性最常见的恶性肿瘤之一,并是发达国家男性常见死因之一。其发生、发展是基因调控失衡的结果,生物学特性与多种癌基因、生长因子密切相关。有研究表明,TGF-β1、VEGF蛋白表达与肿瘤的发生、进展关系密切。但TGF-β1、VEGF对于前列腺癌临床分期及在冷冻治疗前后的预测价值如何,未见文献报道。据此,本研究采用免疫组化方法检测病理标本中TGF-β1、VEGF的表达情况,分析TGF-β1、VEGF表达情况在前列腺癌临床分期中的临床意义；ELISA法检测其在冷冻消融治疗前后血浆中的表达水平,分析TGF-β1、VEGF表达情况与冷冻治疗疗效(PSA缓解率)之间的相关性,以期为不同临床分期前列腺癌患者预后评估及冷冻治疗术后疗效分析提供前期线索。 材料和方法 1.调取2008年1月-2011年12月天津医科大学肿瘤医院收治76例的前列腺癌及40例前列腺增生病理蜡块标本,免疫组化检测标本中TGF-β1、VEGF的表达情况,分析其与临床分期及预后的相关联系。 2.收集2011年11月-2012年12月天津医科大学肿瘤医院我科行冷冻消融治疗的前列腺癌患者,分别于术前和术后7d收集外周血血浆标本,采用ELISA法检测患者血浆中TGF-β1、VEGF的含量。分析其表达情况与患者冷冻术后3月PSA缓解率的相关性。 结果 1. TGF-β1蛋白在前列腺癌中的高表达率为73.68%,在前列腺增生标本中高表达率为35.00%,组间差异具有统计学意义。在Gleason评分2-6分、7分、8-10分三组间的高表达率分别为46.15%、57.89%、88.64%,组间比较,差异具有统计学意义(P0.001)。在无骨转移组中,高表达率为60.61%,合并骨转移组的TGF-β1高表达率为83.72%,组间差异显著,有统计学意义(P=0.023)。在PSA分组、临床分期组间表达差异无统计学意义(P0.05)。 2. VEGF蛋白在前列腺癌标本中的高表达率为63.16%,前列腺增生标本中的高表达率为37.50%,组间差异具有统计学意义(P=0.006)。在Gleason评分2-6分、7分、8-10分三组间的高表达率分别为46.15%、47.36%、75.00%,组间差异具有统计学意义(P0.05)。临床分期Ⅱ期、Ⅲ期、Ⅳ期的高表达率分别为57.14%、40.91%、74.47%,组间差异具有统计学意义(P0.05)。在无骨转移组中,高表达率为46.88%,合并骨转移组的TGF-β1高表达率为75.00%,组间差异有统计学意义(P=0.012)。在PSA分组间的表达差异无统计学意义(P0.05)。 3.前列腺癌组织中VEGF与TGF-β1表达呈正相关性(P0.001),PCa患者中位PFS在TGF-β1(+)、VEGF (+)组较TGF-β1(-)、VEGF (-)组明显延长,组间差异具有统计学意义(P=0.015),而OS在组间比较,差异无统计学意义(P=0.07)。 4.冷冻消融术后3月PSA缓解组TGF-β1表达水平较术前明显下降,而PSA未缓解组TGF-β1表达水平明显升高,差异具有统计学意义(P0.05)。PSA缓解组VEGF表达水平明显下降,差异具有统计学意义(P0.01),而PSA未缓解组表达水平明显升高,但未见统计学差异(P=0.079)。 结论 1. TGF-β1蛋白在前列腺癌中高表达,并随Gleason评分的增高,TGF-β1的表达率明显增高。合并骨转移组较无骨转移组的TGF-β1高表达率也明显增高。 2. VEGF蛋白在前列腺癌中高表达,并随Gleason评分的增高,VEGF的表达率明显增高。临床分期Ⅳ期的VEGF阳性高表达率较Ⅱ期、Ⅲ期明显增高。在合并骨转移组的VEGF较无骨转移组也明显增高。 3.前列腺癌组织中VEGF与TGF-β1表达呈正相关性,二者可能在前列腺癌的发生、发展过程中起协同作用。 4.冷冻消融术后3月PSA缓解组TGF-β1、VEGF表达水平呈现明显下降趋势,而PSA未缓解组表达水平明显升高。对比冷冻治疗前后TGF-β1、VEGF的表达水平,可用来预测冷冻治疗的疗效,可能具有临床指导意义。
[Abstract]:Purpose

Prostate cancer ( PCa ) is one of the most common malignant tumors in males and is one of the most common causes of death in developed countries . The development of TGF - 尾1 and VEGF is closely related to the occurrence and progression of tumors .
The correlation between the expression of TGF - 尾1 , VEGF and the efficacy of cryotherapy ( PSA response rate ) was analyzed by ELISA in order to provide early clues for the prognosis of patients with different clinical stages of prostate cancer and the analysis of curative effect after cryotherapy .

Materials and Methods

1 . The expression of TGF - 尾1 and VEGF was detected in 76 cases of prostate cancer and 40 cases of benign prostatic hyperplasia from January 2008 to December 2011 , and the correlation between clinical stage and prognosis was analyzed .

2 . Collect the peripheral blood plasma samples from November 2011 to December 2012 at the Oncology Hospital of Tianjin Medical University , and collect the plasma samples from peripheral blood before and after operation . The correlation between the expression of TGF - 尾1 and VEGF in the plasma of patients was analyzed by ELISA .

Results

1 . The high expression rate of TGF - 尾1 protein in prostate cancer was 73.68 % , and the high expression rate was 35.00 % in benign prostatic hyperplasia . The high expression rate of TGF - 尾1 was 46.15 % , 57.89 % , 88.64 % , and the difference was statistically significant ( P = 0.023 ) .

2 . The high expression rate of VEGF protein in prostate cancer specimens was 63.16 % , and the high expression rate was 37.50 % in benign prostatic hyperplasia . The high expression rates were 46.15 % , 47.36 % and 75.00 % in the group of Gleason score 2 - 6 , 7 and 8 - 10 , respectively .

3 . The expression of VEGF and TGF - 尾1 was positively correlated with the expression of TGF - 尾1 ( + ) , VEGF ( + ) , TGF - 尾1 ( - ) and VEGF ( - ) in PCa patients .

4 . The expression level of TGF - 尾1 in PSA response group decreased significantly in the PSA response group after cryoablation compared with that before operation ( P0.05 ) . The level of VEGF expression in PSA response group decreased significantly ( P0.01 ) , but the level of VEGF expression in PSA response group was significantly increased , but there was no statistical difference ( P = 0.079 ) .

Conclusion

1 . TGF - 尾1 was highly expressed in prostate cancer , and the expression rate of TGF - 尾1 increased significantly with the increase of Gleason score .

2 . VEGF protein was highly expressed in prostate cancer and increased with Gleason score . The high expression rate of VEGF in stage 鈪，

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