Expression And Clinical Significance Of P-Rb In ? Stage Prostate Adenocarcinoma

Background: Prostate cancer is one of the most common reproductive system malignant tumors which can affect the health of male.Incidence is rising in our country in recent years.About two out of five patients were diagnosed with advanced cancer and have significantly shorter survival compared to early prostate cancer.The factors affecting the prognosis of prostate cancer patients included: age,stage,Gleason score,PSA,nadir PSA values after treatment,time to nadir PSA,hormone sensitive duration and systemic inflammation reaction etc,but it is lack of objective and sensitive predictor of survival and can be effective therapeutic targets or means of intervention.Therefore,looking for prognostic indicators of advanced prostate cancer may be an important way to improve the survival of prostate cancer.Studies have shown that abnormal expression of Rb gene in cancer tissue and Rb protein phosphorylation state associated with the development of a wide variety of tumor,but the study of the relationship between Rb especially phosphorylation Rb(p-Rb)and prostate cancer is relatively rare.Objective: To investigate the clinical significance of the expression of p-Rb in ?stage Prostate adenocarcinoma and its relationship with clinical pathological features,provide a new theoretical basis for the treatment and prognosis judgement of advanced prostatic adenocarcinoma.Methods: A retrospective analysis of the second affiliated hospital of Da Lian Medical university from January 2005 to September 2016 admitted 50 cases of primary adenocarcinoma of prostate patients,all patients were confirmed by pathology of ?stage prostatic adenocarcinoma,all occurred castration resistance after androgen deprivation therapy.Meanwhile,normal prostate tissues of 20 cases during the same period in our hospital were collected as control.Using immunohistochemical method to detect the expression of p-Rb in prostate cancer tissue,using statistical methods to analyze the correlations between the protein expression and clinical pathological characteristics of ?stage patients and the relationship between the both and the parameters such as TTCRPC,PFS after CRPC,OS after CRPC and OS.Result: 50 patients aged 50-89 years old;the median age was 72 years old.The median TTCRPC was 17.3 months(1.4-105.7 months),the median PFS after CRPC was 3.9 months(1-40.4 months),the median OS after CRPC was 16.7 months(2.4-62.9 months),and the median OS was 48.1 months(6.3-120.2 months).1.p-Rb positive rate(88%)in patients with prostatic adenocarcinoma was obviously higher than normal prostate tissues(20%),and its high expression rate(46%)was obviously higher than normal prostate tissues(0%),the difference had statistical significance(p<0.05).The expression of p-Rb was significantly correlated with Gleason score,nadir PSA level after treatment,time to nadir PSA and TTCRPC(p<0.05).There were no statistical difference with age,ways of initial treatment,baseline PSA,ALP,LDH,platelet count,PLR,HGB,transfer site and chemotherapy(p>0.05).2.The univariate analysis indicated that the expression of p-Rb,Gleason score,time to nadir PSA level and HGB was significantly correlated with the TTCRPC(p<0.05).There were no statistical difference between TTCRPC with age,ways of initial treatment,baseline PSA,nadir PSA level,ALP,LDH,platelet count,PLR and transfer site(p>0.05).Multivariate analysis showed that the expression of p-Rb,Gleason score and HGB were the independent prognostic factors in TTCRPC to patients with ?stage prostate cancer(p<0.05).3.The univariate analysis indicated that the expression of p-Rb,Gleason score,time to nadir PSA level and TTCRPC was significantly correlated with the PFS after CRPC(p<0.05).There were no statistical difference between PFS after CRPC with age,ways of initial treatment,baseline PSA,nadir PSA level,ALP,LDH,platelet count,PLR,HGB,transfer site and chemotherapy(p>0.05).Multivariate analysis showed that the TTCRPC was the independent prognostic factors in PFS after CRPC for patients with ?stage prostate cancer(p<0.05).4.The univariate analysis indicated that the Gleason score,PSA,LDH,time to nadir PSA level and TTCRPC was significantly correlated with the OS after CRPC(p<0.05).There were no statistical difference between OS after CRPC with the expression of p-Rb,age,ways of initial treatment,baseline PSA,nadir PSA level,ALP,platelet count,PLR,HGB,transfer site and chemotherapy(p>0.05).Multivariate analysis showed that the Gleason score,LDH and TTCRPC were the independent prognostic factors in OS after CRPC for patients with ?stage prostate cancer(p<0.05).5.The univariate analysis indicated that the Gleason score,time to nadir PSA level,LDH,chemotherapy and TTCRPC was significantly correlated with the OS(p<0.05).There were no statistical difference between OS with the expression of p-Rb,age,ways of initial treatment,baseline PSA,nadir PSA level,ALP,platelet count,PLR,HGB and transfer site(p>0.05).Multivariate analysis showed that the Gleason score,LDH and TTCRPC were the independent prognostic factors in OS for patients with ?stage prostate cancer(p<0.05).Conclusion: 1.Compared with the normal prostate tissue,p-Rb was high expressed in ?stage prostate adenocarcinoma tissue,there were significant correlations with Gleason score,nadir PSA level after treatment,time to nadir PSA and TTCRPC,Prompt its can reflect the biological behavior of the ?stage prostate adenocarcinoma.2.The expression of p-Rb is an independent predictor of TTCRPC of patients with ?stage prostatic adenocarcinoma.3.There were no relationship between the OS after CRPC and OS of ?stage prostatic adenocarcinoma with the expression of p-Rb,but was significantly correlated with Gleason score,LDH and TTCRPC;the PFS after CRPC was only correlated with TTCRPC.