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目的探究手术去势治疗联合雄激素阻断治疗(androgen deprivation therapy,ADT)对前列腺癌患者症状及肿瘤干细胞的影响。方法选取我院2013年1月至2015年1月收治的前列腺癌患者82例,根据随机数表法分为观察组和对照组各41例,对照组实施手术去势治疗,观察组在其基础上联合ADT。9个月后所有患者接受根治性前列腺切除。比较两组患者相关临床症状和肿瘤干细胞的情况。结果治疗后观察组下尿路症状明显改善,差异有统计学意义(P<0.05)。对照组治疗前后干细胞抗原(stem cell antigen,SCA)mRNA阳性率及表达含量差异均无统计学意义(P>0.05),观察组治疗后SCAmRNA阳性率及表达含量均显著下降(31.71%vs78.05%,22.59±8.03μg/Lvs 74.05±9.35μg/L),差异均有统计学意义(P<0.05),且减少程度与治疗前肿瘤的Gleason评分有关,Gleason评分越高,阳性肿瘤细胞减少的百分比越高。对照组治疗前后CD44和整合素α2β1双标阳性干细胞比例无明显变化,而观察组治疗后显著下降[(9.33±1.63)%VS(3.48±1.16)%,t=18.723,P<0.05]。结论 ADT联合手术去势治疗可有效改善症状,降低SCAmRNA阳性表达率和肿瘤干细胞比例,值得临床进一步分析应用。
Objective To investigate the effect of surgical castration combined with androgen deprivation therapy (ADT) on the symptoms and tumor stem cells in patients with prostate cancer. Methods Eighty-two patients with prostate cancer were selected from January 2013 to January 2015 in our hospital. According to the random number table, 41 cases were divided into observation group and control group. The control group was treated by castration. On the joint ADT. All patients underwent radical prostatectomy 9 months later. The clinical symptoms and tumor stem cells were compared between the two groups. Results After treatment, the symptoms of lower urinary tract in observation group were significantly improved (P <0.05). There was no significant difference in the positive rate and the expression of SCA mRNA between the two groups before and after treatment (P> 0.05). The positive rate and the expression of SCA mRNA in the control group were significantly decreased (31.71% vs 78.05 %, 22.59 ± 8.03μg / L vs 74.05 ± 9.35μg / L), the difference was statistically significant (P <0.05), and the degree of reduction was related to the Gleason score of the pretreatment tumor. The higher the Gleason score, the less the positive tumor cells The higher the percentage. There was no significant difference in the percentage of CD44 and integrin α2β1 double-labeled positive stem cells in the control group before and after treatment, while the observation group had a significant decrease (9.33 ± 1.63)% VS (3.48 ± 1.16)% and t = 18.723, P <0.05 after treatment. Conclusion ADT combined with surgical castration can effectively improve the symptoms and reduce the positive rate of SCA mRNA and the proportion of tumor stem cells, which is worth further clinical application.