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目的探讨睾酮5-α还原酶Ⅱ(SRD5A2)基因多态性与影响前列腺癌预后因素的关系。方法对112例前列腺癌患者(前列腺癌组)与89例前列腺增生患者(前列腺增生组)的SRD5A2基因89密码子亮氨酸替代缬氨酸(V89L)及49密码子苏氨酸替代丙氨酸(A49T)多态性位点进行酶切鉴定,了解V89L及A49T基因多态性分布情况的差异,及基因多态性与前列腺癌患者的年龄、血游离前列腺特异抗原(PSA)、总PSA、游离PSA／总PSA值、Gleason评分、临床分期的关系。结果前列腺癌组与前列腺增生组V89L和A49T基因频度风险无显著性差异(分别为0.040与0.045,0.308与0.399,x2值为0.047、3.606,P均>0.05)。前列腺癌组AT+TT基因型患者的发病年龄[(65±9)岁]明显低于AA基因型者[(71±7)岁](P=0.03),Gleason评分平均水平明显高于AA基因型(P=0.015)。VV和VL+LL基因型各评价预后指标差异无显著性。分段评价PSA水平、Gleason评分、临床分期、年龄,均与两种基因型无相关性。结论AT+TT基因型前列腺癌患者的预后可能较差,VL+LL基因型与预后无明显关系。
Objective To investigate the relationship between the polymorphism of testosterone 5-α reductase Ⅱ (SRD5A2) and the prognosis of prostate cancer. METHODS: The SRD5A2 gene 89 codon leucine instead of valine (V89L) and the 49 codon threonine were substituted for alanine in 112 prostate cancer patients (prostate cancer group) and 89 benign prostate hyperplasia patients (benign prostatic hyperplasia group) (A49T) polymorphisms to find out the differences in the distribution of V89L and A49T polymorphisms and the relationship between the genetic polymorphisms and the age, blood PSA, total PSA, Free PSA / total PSA, Gleason score, clinical stage. Results There was no significant difference in the frequency of V89L and A49T between the prostate cancer group and benign prostatic hyperplasia group (0.040 and 0.045, 0.308 and 0.399, respectively, and the x2 values were 0.047 and 3.660, all P> 0.05). The age at onset of AT + TT genotype in patients with prostate cancer was significantly lower than that in patients with AA genotype [(71 ± 7) years old (65 ± 9) years (P = 0.03), Gleason score was significantly higher than AA Type (P = 0.015). VV and VL + LL genotype evaluation of prognostic indicators no significant difference. The PSA level, Gleason score, clinical stage and age were assessed by sub-section, and no correlation was found between the two genotypes. Conclusion The prognosis of patients with AT + TT genotype prostate cancer may be poor, and the genotype of VL + LL has no significant relationship with prognosis.