Editorial Comment on: ADAM9 Expression is a Significant and Independent Prognostic Marker of PSA Relapse in Prostate Cancer

摘要

Epidermal growth factor, insulin-like growth factor, and mutations of androgen receptor play a role in the progression of hormone-sensitive prostate cancer to hormone insensitivity.Although hormonal therapy is used earlier in the course of disease and a primary response rate of 80-90% occurs with hormonal ablation, almost all patients advance to a state of androgen independence manifested by increasing prostate-specific antigen (PSA) levels and new lesions on bone scans. The median survival time in patients withandro-gen-independent prostate cancer is about 18 mo and this condition is also accompanied by the attainment of high resistance to cytotoxic drugs . Androgen independence may be an intrinsic, but resting, property of some prostate cancer cells that are activated in response to androgen deprivation. Only epithelial cells, not basal or stromal cells, undergo apoptosis on androgen withdrawal. The clonal selection hypothesis relates to the selective survival of preexisting androgen-independent cells within the tumour by hormonal deprivation . These clonal cells are thought to be poorly differentiated and similar to basal or stem cells .