ADAM9, B7-H3, KPNA2 & ANXA7 And Prostate Specific Antigen Half Life, Decreasing Velocity, Doubling Time Predict The Prognosis Of Prostate Cancer

ADAM9,B7-H3,KPNA2＆ANXA7 and prostate specific antigen half life,decreasing velocity,doubling time predict the prognosis of prostate cancerObjective:1.To explore the expression of ADAM9,B7-H3,KPNA2 and ANXA7 in prostate cancers and evaluate the relation between these expressions and disease progression or prognosis for prostate cancers.2.To explore the relation between PSA kinetic parameters:PSA half life (PSAHL),PSA decreasing velocity(PSAVd)＆PSA doubling time(PSADT) and prognosis for prostate cancers.Methods:1.The datas and tissue specimens about the 128 advanced prostate cancers including 106 hormonal sensitive patients and 22 cases of HRPC patients from May,2002 to Dec,2008 in our hospital were collected.20 cases of BPH patients were considered as a control group.All the paraffin block had been sliced for immunohistochemistry of ADAM9,B7-H3,KPNA2 and ANXA7.To explore the expression of ADAM9,B7-H3,KPNA2 and ANXA7 for prostate cancers especially compareing the difference betwen HRPC and hormonal sensitive patients.To compare the relationship between the four factors and clinical and pathological features including age, initial PSA value,clinical TNM stage and biopsy Gleason score.Cox regression model was used to analyse the relation between expression of the four factors and progression-free survival(PFS) and overall survival(OS) for 106 hormonal sensitive prostate cancers.2.The datas about 153 cases advanced prostate cancers form May,2002 to Ded,2008 in our hospital were collected.To use the equation,the PSA kinetic parameters including PSAHL,PSAVd and PSADT were calculated according to the blood PSA concentrations.To compare the realtionship between the PSA kinetic parameters and clinical and pathological features including age,initial PSA value,TNM stage,biopsy Gleason score and PSA nadir.Cox regression model was used to analyse the relation between PSA kinetic parameters and PFS and OS for 153 advanced prostate cancers.Result:1.①The expression level of ADAM9,B7-H3 and KPNA2 increased significantly as disease progressed from BPH to advanced prostate cancer(P=0.O11,0.002 and 0.002 ) and the expression level of ANXA7 decreased significantly as disease progressed from BPH to prostate cancer(P＜0.001).②The expression level of ADAM9 and B7-H3 for HRPC patients were significantly higher than the hormonal sensitive patients(P=0.009 and 0.040).The expression level of ANXA7 for HRPC patients were significantly lower than the hormonal sensitive patients(P=0.035). There was no significantly statistical difference of KPNA2 expression between the two group(P=0.073).③For advanced prostate cancer,none of the expression level of four factors were correlated to the clinical and pathological features(P >0.05).④We compared the relationship between the four factors and the results indicated that only the expression of ADAM9 was positive correlated to ANXA7(P＜0.001).⑤The univariate and multivariate analysis for the PFS of hormonal sensitive prostate cancers indicated that the positive expression of ADAM9,B7-H3 and negative expression of ANXA7 and biopsy Gleason score≥8were relative with the poor PFS(P=0.025,0.002,0.042 and 0.009) and the positive expression of ADAM9,B7-H3,KPNA2 and negative expression of ANXA7 were relative with the poor OS respectively(P=0.021, <0.001,0.003 and＜0.001).2.①The median PSAHL was 0.5months.It was relative with T stage and nadir PSA(P=0.042 and＜0.001).The median PSAVd was 20 ng·m1~-1·mo~-1.It was relative with T stage,N stage and initial PSA(P=0.028,0.002 and＜0.001).The median PSADT was 2.Omonths.There was no relationship between PSADT and clinical and pathological features.②On univariate and multivariate analysis,Ml stage,biopsy Gleason score≥8,PSAHL?0.5months,nadir PSA＞0.4ng/ml were significantly was positively correlated with PSAHL＞0.5months,nadir PSA＞0.4ng/ml and PSADT≤2.Omonths(P=0.026,0.024 and＜0.001).Conclusion:According to the cell factors,the positive expression of ADAM9,B7-H3 and negative expression of ANXA7 were positive relative with the disease progression from hormonal sensitiveness to hormonal refractory.All of them were the prognosis factors of poor PFS and OS.The positive expression of KPNA2 was only the prognosis factor of poor OS.According to the PSA kinetic parameters,PSAHL＞0.5months was the prognosis factors of poor PFS and OS. PSADT≤2.Omonths was the prognosis factors of poor OS.