摘要目的 探讨ERG及SPINK1蛋白在前列腺癌中的表达及其与预后的相关性.方法 选取进行内分泌治疗的前列腺癌穿刺标本118例,应用免疫组织化学EnVision法检测ERG及SPINK1蛋白在前列腺癌及正常前列腺组织中的表达情况,分析两者的表达与临床病理特征及预后之间的关系.结果 118例前列腺癌活检标本中11例ERG蛋白表达阳性(11/118,9.3％),SPINK1蛋白在13例前列腺癌穿刺标本中表达阳性(13/118,11.0％).未发现同时表达两种蛋白的病例.ERG阳性的患者具有较低的T分期(P =0.001),而患者的发病年龄、血清总前列腺特异性抗原(PSA)值、Gleason评分、肿瘤范围、远处转移等与ERG的表达均无相关性.SPINK1的表达与上述各项参数也无相关性.7例SPINK1阳性的患者(7/13)在治疗过程中出现了远处转移或者肿瘤相关性的死亡,相对于阴性的病例,具有较短的疾病进展时间(P =0.022).根据ERG和SPINK1蛋白的表达情况将患者分为ERG +/SPINK1-、ERG-/SPINK1+以及ERG-/SPINK1-3组,分析其与疾病进展的相关性,显示3组之间差异有统计学意义,ERG-/SPINKI+组的患者与疾病进展具有显著相关性(P =0.029).结论 SPINK1和ERG蛋白的表达具有相互排斥性.前列腺癌中SPINK1蛋白的阳性表达与疾病进展之间存在明确相关性,可以作为判断患者预后的一个指标.

abstractsObjective To study the expression and prognostic significance of ERG and SPINK1 expression in endocrine-treated prostatic cancer.Methods Prostatic needle biopsies from 118 prostatic cancer patients primarily treated with endocrine therapy were reviewed.Immunohistochemical study for ERG and SPINK1 protein was carried out.Results Co-expression of ERG and SPINK1 was not observed.The frequency of ERG protein expression in the 118 biopsies studied was 9.3％ (11/118).The positive expression correlated with T stage (P =0.04) but not with patient age at diagnosis,prostatic specific antigen level,Gleason's score,M stage,tumor area and progression-free survival.Positive expression of SPINK1 was demonstrated in 11.0％ (13/118) of the biopsies.SPINK1-positive cases carried a significantly shorter progression-free survival,as compared with SPINK1-negative cases (P =0.022).The expression was not associated with any other clinicopathologic variables.The following expression pattern showed statistically significant correlation with the clinical progress (P =0.029):ERG +/SPINK1-(11/118,9.3 ％),ERG-/ SPINK1 + (13/118,11.0％) and ERG-/SPINK1-(94/118,79.7％).Conclusions ERG and SPINK1 proteins are mutually exclusive.SPINK1 expression is associated with more aggressive clinical behavior and can serve as a prognostic biomarker in prostatic cancer.