| BackgroundProstate cancer (Pca) is a common tumor in the west countries which lie in Europe and America. In our country, the incidence of Pca is rising year after year, with the growing population aging,adjusting dietary structure and improving technology clinic. Population aging is one of dangerous factors to catch Pca, over 70 percent of sufferers are beyond 65 years old when they had been diagnosed. There are many ways to treat Pca such as radical prostatectomy,endocrine therapy,radiotherapy,chemotherapy,immunotherapy, and so on. How to choose appropriate treatment and avoid excessive treating or indulging, urologists must estimate the prognosis of the tumor when the case is diagnosed.At present, urologists use prostate specific antigen (PSA) as the main index point to screen and diagnose Pca, and use Gleason grade as the main index point to judge the malignant degree and the prognosis of the tumor. However, the index points above have obvious deficiency: PSA rises in the cases such as benign prostatic hyperplasia (BPH),prostatitis,even after the operation of urethra or rectum, it lacks of specificity;Gleason grade depends on the experience and level of pathologist and the quality of sections, it has particularly subjectivity and randomness. Therefore, professionals in correlative field as urology and pathology etc are trying their best to find a biomark with highly specificity and highly sensitiveness which can brief us exactly on the prognosis of Pca.Connexin 43 (Cx43) belongs to the family of connexion (Cx), Cx can be found in common tissues widely.They locate on the adjacent surface of cells, and compose the transmembrance channels which communicate the adjacent cells, called connexion. They compose gap junction plaques on the plasmolemma which relate to the function of gap junction (GJ) and gap junction intercellular communication (GJIC). It is a common phenomenon that Cx43 express abnormally in tumor cells, the expression of Cx43 reduce in some tumors, then these tumors have more abilities to invade and attack.ObjectiveWe research the cases which were diagnosed Pca and followed up over 2 years during January of 2005 to December of 2007 in our hospital and KaiLuan Hospital by experience, in order to investigate the relationship between the expression of Cx43 in the tissues of Pca and the measured value of serum PSA,Gleason grade,clinical stages,metastasis and recurrence of Pca, and evaluate the clinical value that Cx43 is used as a biomark to detect the prognosis of Pca.Materials and methodsTo set up a clinical database with the 76 cases which were diagnosed Pca and followed up over 2 years during January of 2005 to December of 2007 in our hospital and KaiLuan Hospital. Patients′age are from 52 to 86, medianage is 71.5. There are 11,17,22,26 in the clinical stages′A,B,C,D separately, 13 cases′measured value of serum PSA are lower than 10 ng/ml, 22 cases′PSA are 10-20 ng/ml, and 41 cases′PSA are over 20 ng/ml.The pathology samples of the cases is divided into well differentiated cancer,moderately differentiated cancer and poorly differentiated cancer by Gleason grade, there are 26, 22, 28 cases in each cancer separately. The source of samples: 14 cases are incidental cancers by TURP or resection of the prostate by bladder, 47 cases are diagnosed by biopsy through rectum, 15 cases are diagnosed by radical prostatectomy. 9 cases which belong to A or B clinical stage metastasized within two years after bing diagnosed, and 29 cases entered the period of androgen independent prostate cancer within two years after being diagnosed(The standard is according to the rising obviously of PSA after treatment), 20 samples in the same period and the similar ages of BPH are used as the control group. To detect Cx43 in 76 samples of prostate cancer tissues and 20 samples of BPH tissues with immunohistochemical method , and analysis the correlativity between expression of Cx43 and measured value of serum PSA,Gleason's grade,age,clinical stages,metastasis,recurrence of prostate cancer.Result1. Positive staining of Cx43 protein is located in epicyte and cytoplasm. Positive expressive rate of Cx43 in prostate cancer is apparently lower than that in BPH(P<0.01).2. The result to compare the positive expressive rate between different ages has shown no statistical significance(P>0.05).3. In the samples of prostate cancer, measured value of serum PSA,Gleason's grade and clinical stages are higher, positive expressive rate of Cx43 protein is apparently lower, moreover it is much lower in the cases which had metastasized or entered the period of Androgen Independent Prostate Cancer within two years.(P<0.05 or P<0.01).Conclusion1. The expression of Cx43 in the Pca is apparently lower.2. The positive expressive rate of Cx43 protein in Pca is negative correlative with measured value of serum PSA,Gleason grade and clinical stages, it is closely related with the metastasis and recurrence of the tumor.3. The generation and metastasis of prostate cancer can be inhibited by Cx43, it is a biological marker which can be used to determine the biological behaviour and prognosis of prostate cancer.
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