CRISP3 glycoprotein: a good biomarker for prostate cancer?

ABSTRACT Introduction: Cysteine-rich secretory protein 3 (CRISP3) is expressed at low levels in normal human prostate but often overexpressed in prostate cancer (PCa). The relevance of this overexpression for the malignancy of PCa is still unclear. The prognostic value of the currently used prostate specific antigen (PSA) test can be misleading under certain circumstances, resulting in overtreatment of indolent tumors. New biomarkers are needed to reduce overtreatment and improve quality of life of men. Objective: Evaluate if CRISP3 expression could be a good biomarker for PCa. Methods: CRISP3 expression was determined by immunohistochemistry in tissue sections of prostate cancer from twenty-five patients subjected to radical prostatectomy. Gleason grading system was used as prognostic indicator and the staging of PCa was defined using the TNM system. Clinical parameters and PSA levels before and after surgery were determined. Results: CRISP3 expression was strong in 14 (56%), moderate in four (16%) and weak in seven (28%) specimens. There was no correlation between the intensity of CRISP3 expression and pre- and post-treatment PSA levels. Fifteen (60%) of PCa biopsies showed extension of the primary tumor pT2. Seven patients (28%) showed Gleason score higher than 7; thirteen (52%) equal to 7, and five (20%) lower than 7. There were no significant statistical differences between Gleason score and CRISP3 expression. Conclusion: CRISP3 is expressed in prostate cancer at different levels. Additional studies are required to better evaluate if CRISP3 could be used as a biomarker.

摘要
引言：富含半胱氨酸分泌蛋白3（Cysteine-rich secretory protein 3，CRISP3）在正常人体前列腺组织中呈低表达状态，而在前列腺癌（prostate cancer, PCa）组织中常出现过表达。该过表达与前列腺癌恶性程度的相关性目前仍不明确。当前临床广泛使用的前列腺特异性抗原（prostate specific antigen, PSA）检测在部分临床场景中可能存在误导性，易导致惰性肿瘤患者接受过度治疗，因此亟需新型生物标志物以减少过度诊疗，改善男性前列腺癌患者的生活质量。
研究目的：评估CRISP3表达是否可作为前列腺癌的有效生物标志物。
研究方法：纳入25例行根治性前列腺切除术的前列腺癌患者，采用免疫组化法检测其前列腺癌组织切片中的CRISP3表达水平；以格里森分级系统作为预后评估指标，采用TNM分期系统明确前列腺癌的临床分期；同时检测患者术前与术后的临床参数及PSA水平。
研究结果：14例（56%）标本的CRISP3表达呈强阳性，4例（16%）呈中等阳性，7例（28%）呈弱阳性。CRISP3表达强度与术前、术后PSA水平均无显著相关性。60%（15例）的前列腺癌活检标本显示原发肿瘤处于pT2分期。7例（28%）患者的格里森评分高于7分，13例（52%）等于7分，5例（20%）低于7分。格里森评分与CRISP3表达水平之间未发现显著统计学差异。
研究结论：CRISP3在前列腺癌组织中呈不同水平的表达。未来需开展更多相关研究，以进一步明确CRISP3是否可作为前列腺癌的临床生物标志物。