2013-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/645727摘要：攝護腺癌冷凍治療是一新興之治療方式。少數研究指出，冷凍治療後大量之腫瘤抗原從破裂之細胞釋出，會造成抗腫瘤之免疫反應，進而增強對殘餘腫瘤細胞之殺傷。此外，血清中循環腫瘤細胞（circulating tumor cells, CTCs）治療前後之變化，可能可以做為多種癌症之預後因子。此兩種對攝護腺癌冷凍治療之反應（免疫及CTCs），過去並無深入前瞻性長期追蹤之研究。本計劃是研究攝護腺癌冷凍治療（N=100）後，組織及血液中，免疫指標及血清中循環腫瘤細胞之變化，屬於轉譯性研究。為了比較，本計劃也會收集少數接受根除性攝護腺切除術（N=30），及放射線治療（N=30）病人的組織及血液檢體。吾人將收集臨床病理參數、癌症控制結果及生活品質問卷，當作是臨床治療結果之指標。臨床檢體，包括周邊血液（分為血清及血球）及攝護腺切片之蠟塊組織，以便進行轉譯性實驗室研究。我們會在攝護腺癌治療前及後之定點時間，為受試者抽血，收取周邊血液單核細胞（peripheral blood mononuclear cell, PBMC）及血清中之細胞激素（cytokines）。血液週邊之單核球(PBMC)將分別研究免疫細胞族群之變化，及循環腫瘤細胞之定性及定量。血清細胞激素則用以測定免疫及抗腫瘤有關之功能。此外，攝護腺切片之蠟塊標本，也會進行免疫組織化學染色（immunohistochemical staining），以研究免疫反應及抗腫瘤效應。本研究預定進行 3 年10 月，前15 月預定前瞻性收案160 位病人（包括在本計畫起始前10 個月，即開始收案），後2~3 年為追蹤期，並且會以各種免疫指標及循環腫瘤細胞量之變化，與臨床結果作相關分析，找出可能有意義的指標，以早期預測疾病之復發。<br> Abstract: Prostate cryotherapy is among new treatment modalities for localized prostatecancer. A few studies showed that tumor antigens released during cell rupture aftercryoablation lead to significant anti-tumor immunity which is responsible for killing ofresidual tumor cells. It has also been shown that quantitative changes of circulatingtumor cells (CTC) may become useful prognostic factors in the management of avariety of human cancers. However, both immunological reactions and CTC have notbeen prospectively and extensively studied in the setting of prostate cryotherapy.The translational study aims to determine the serial changes of serum immuneprofiles and circulating tumor cells in subjects who undergo prostate cryotherapy(N=100) for localized prostate cancer. A smaller number of subjects who choose toundergo radical prostatectomy (N=30) and definitive radiotherapy (N=30) will also berecruited to serve as controls. We will collect clinicopathological parameters,oncological follow-up data, and quality of life questionnaire data to serve as clinicaloutcome parameters. We will also collect clinical samples, including peripheral blood(serum and cells in blood) and prostate biopsy paraffin blocks for translational studies.Peripheral blood will be sampled before and after definitive treatments atpre-determined time points. Peripheral blood mononuclear cells (PBMC) will subjectto immune cell population analyses and determination of circulating tumor cellsqualitatively and quantitatively. Serum cytokines related to host immunity andresponses to treatments will be determined. In addition, prostate biopsy paraffinblocks will subject to immunohistochemical staining for immune profiles andanti-tumor effects.The study will span for 3 years and 10 months, including prospectively recruiting160 subjects in the first 15 months year (recruitment has begun 10 months prior to thecurrent study) and a follow-up phase in the second and third years. Laboratoryparameters will then be correlated with clinical outcome parameters to identifypotential predictive or prognostic markers for treatment.