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Tran PT, Hales RK, Zeng J, Aziz K, Salih T, Gajula RP, Chettiar S, Gandhi N, Wild AT, Kumar R, Herman JM, Song DY, DeWeese TL. Tissue biomarkers for prostate cancer radiation therapy. Curr Mol Med 2012; 12:772-87. [PMID: 22292443 PMCID: PMC3412203 DOI: 10.2174/156652412800792589] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 11/10/2011] [Accepted: 12/20/2011] [Indexed: 12/12/2022]
Abstract
Prostate cancer is the most common cancer and second leading cause of cancer deaths among men in the United States. Most men have localized disease diagnosed following an elevated serum prostate specific antigen test for cancer screening purposes. Standard treatment options consist of surgery or definitive radiation therapy directed by clinical factors that are organized into risk stratification groups. Current clinical risk stratification systems are still insufficient to differentiate lethal from indolent disease. Similarly, a subset of men in poor risk groups need to be identified for more aggressive treatment and enrollment into clinical trials. Furthermore, these clinical tools are very limited in revealing information about the biologic pathways driving these different disease phenotypes and do not offer insights for novel treatments which are needed in men with poor-risk disease. We believe molecular biomarkers may serve to bridge these inadequacies of traditional clinical factors opening the door for personalized treatment approaches that would allow tailoring of treatment options to maximize therapeutic outcome. We review the current state of prognostic and predictive tissue-based molecular biomarkers which can be used to direct localized prostate cancer treatment decisions, specifically those implicated with definitive and salvage radiation therapy.
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Affiliation(s)
- P T Tran
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, 1550 Orleans Street, CRB2, RM 406, Baltimore, MD 21231, USA.
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Padmanabhan V, Callas P, Philips G, Trainer TD, Beatty BG. DNA replication regulation protein Mcm7 as a marker of proliferation in prostate cancer. J Clin Pathol 2004; 57:1057-62. [PMID: 15452160 PMCID: PMC1770448 DOI: 10.1136/jcp.2004.016436] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent studies have shown that minichromosome maintenance (MCM) proteins (Mcm2-7) may be useful proliferation markers in dysplasia and cancer in various tissues. AIMS To investigate the use of Mcm7 as a proliferation marker in 79 lymph node negative prostate cancers and compare it with Ki-67, a commonly used cell proliferation marker. METHODS The percentage of proliferating cells (proliferation index; PI) was calculated for basal and luminal epithelial cells in benign prostate tissue, prostatic intraepithelial neoplasia (PIN), and epithelial cells in adenocarcinoma. The PI for each biomarker was correlated with the preoperative prostate specific antigen concentration, the Gleason score, surgical resection margin status, and the AJCC pT stage for each patient. RESULTS The mean PIs for Ki-67 and Mcm7 were: benign luminal epithelium 0.7 and 1.2 and benign basal epithelium 0.8 and 8.2; PIN non-basal epithelium 4.9 and 10.6 and PIN basal epithelium 0.7 and 3.1; adenocarcinoma 9.8 and 22.7, respectively. Mcm7 had a significantly higher mean PI (p<0.0001) than Ki-67 for all cell categories except benign luminal epithelial cells. Mcm7 was a better discriminatory marker of proliferation between benign epithelium, PIN, and invasive adenocarcinoma (p<0.0001) than Ki-67. The drop in Mcm7 mean basal cell PI from benign epithelium to PIN epithelium was significantly larger than for Ki-67 (p<0.0001). Mcm7 had a significantly higher PI than Ki-67 at each risk level. CONCLUSION Mcm7 may be a useful proliferation marker in prostatic neoplasia and warrants further evaluation as a complementary tool in the diagnosis of PIN and prostate carcinoma.
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Affiliation(s)
- V Padmanabhan
- Department of Pathology, University of Vermont, Burlington, VT 05405, USA
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Loukopoulos P, Thornton JR, Robinson WF. Clinical and pathologic relevance of p53 index in canine osseous tumors. Vet Pathol 2003; 40:237-48. [PMID: 12724563 DOI: 10.1354/vp.40-3-237] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The clinicopathologic value of the immunohistochemical (IHC) expression of p53 protein was evaluated in 167 canine osseous tumors. p53 staining frequency and intensity in tumor cells was expressed as a p53 index. p53 index was significantly higher in osteosarcomas than in other sarcomas, chondrosarcoma, multilobular tumor of bone, and tumors initially misdiagnosed as osteosarcomas as well as in appendicular versus axial and in distal versus proximal osteosarcomas. A strong correlation is demonstrated between the p53 index and a range of clinicopathologic parameters in osteosarcoma, including the tumor site, histologic grade and score, mitotic index, degree of tumor necrosis, and pleomorphism. Chondroblastic osteosarcomas had significantly higher and telangiectatic osteosarcomas significantly lower p53 index than did osteosarcomas belonging to other histopathologic subtypes, a fact that tends to reinforce the perception of these osteosarcomas as distinct clinicopathologic entities. Entire males had higher p53 index than did neutered males. p53 index was higher in Rottweilers than in Great Danes and Terriers, confirming breed susceptibilities to osteosarcoma. p53 index showed no association with age, primary or secondary site status, or the presence of metastases or other tumor types. Biopsy samples had a higher p53 index than did postmortem samples, either because of differences in sample processing or the possibility that p53 overexpression is more evident at the earlier stages of osteosarcoma pathogenesis, presumably represented by the biopsy material. IHC examination for p53 and the derived index has the potential to be used as an additional diagnostic tool and prognostic indicator for osseous tumors.
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Affiliation(s)
- P Loukopoulos
- School of Veterinary Science, The University of Queensland, Brisbane, Australia.
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4
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Abstract
P53 is a tumor-suppressor gene that codes for a multifunctional DNA-binding protein involved in cell cycle arrest, DNA repair, differentiation, and apoptosis. The P53 gene is mutated in approximately 50% of human cancers and in germline DNA of families with inherited cancer syndromes. The role of P53 mutations in the program of carcinogenic genetic alterations differs among tumor sites ranging from the earliest mutations that can be detected in premalignant cells to mutations that trigger malignant transformation of a benign neoplasm. P53 mutations can cause expression of abnormal proteins or result in complete absence of P53 expression. For these reasons the role of P53 genetic disruption has different implications in different tumor types and may vary depending on the effect of the mutation on P53 protein function. Immunohistochemical detection of P53, commonly used as a surrogate for identification of a mutant gene, has imperfect sensitivity and specificity, further complicating correlations between P53 gene status and clinical outcomes. The presence of P53 mutations has been shown to affect prognosis of some cancers. The identity of P53 mutations can be used to determine tumor clonality. The detection of P53 mutations suggests the severity of premalignant lesions. Evolving technology for more accurate identification of P53 mutations, better understanding of the function of mutant P53 protein, and more detailed analysis of individual tumor types may expand the relevance of P53 gene analysis for clinical outcomes and therapeutic response.
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Affiliation(s)
- Minetta C Liu
- Department of Oncology, Lombardi Cancer Center, Georgetown University School of Medicine, Washington, DC 20007, USA
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Genç E, Hoşal AS, Gedikoğlu G, Ozyar E, Sözeri B. Prognostic value of p53, proliferating cell nuclear antigen, and Ki-67 expression in undifferentiated nasopharyngeal carcinomas. Otolaryngol Head Neck Surg 2000; 122:868-73. [PMID: 10828801 DOI: 10.1016/s0194-59980070016-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this study the prognostic importance of p53, proliferating cell nuclear antigen (PCNA), and Ki-67 expression was analyzed along with the clinical parameters in 35 consecutive patients with undifferentiated nasopharyngeal carcinomas. Immunohistochemistry was used to detect p53, PCNA, and Ki-67 staining. Among the clinical findings, stage IV disease (P = 0.01), cranial nerve paralysis (P = 0.02), and lymph node metastasis (P = 0.06) were associated with shorter survival. The p53 positivity correlated with the presence of lymph nodes, but it was not a significant factor to predict the outcome. PCNA expression was not found to be a prognostic indicator. On the other hand, the proliferative value of Ki-67 staining was suggestive of prognosis. A proliferation index of Ki-67 less than 10% indicated longer survival (P = 0.03). There was no correlation between Ki-67 staining and PCNA index. As a result, the prognostic value of Ki-67 may alert the physician to more aggressive and adjuvant treatment modalities.
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Affiliation(s)
- E Genç
- Departments of Otolaryngology-Head and Neck Surgery, Pathology, and Radiation Oncology, Hacettepe University Medical Faculty, Anakra, Turkey
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Stackhouse GB, Sesterhenn IA, Bauer JJ, Mostofi FK, Connelly RR, Srivastava SK, Moul JW. p53 and bcl-2 immunohistochemistry in pretreatment prostate needle biopsies to predict recurrence of prostate cancer after radical prostatectomy. J Urol 1999; 162:2040-5. [PMID: 10569564 DOI: 10.1016/s0022-5347(05)68095-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Immunohistochemical staining of radical prostatectomy specimens for p53 and bcl-2 proteins has been shown to correlate with prostate specific antigen (PSA) recurrence in a series of patients at our institution. We analyzed the relationship between staining of diagnostic prostate needle biopsies for p53 and bcl-2, and PSA recurrence. MATERIALS AND METHODS From 1986 to 1993, 335 radical prostatectomies were performed at our hospital. Of the prostatectomy specimens 199 had been evaluated for p53 and bcl-2 proteins in a prior series. Of 139 patients with biopsy material available for analysis 129 had enough for evaluation of 1 or both markers. Prospectively obtained clinical followup data were available, with a mean followup of 6 years. Commercially available antibodies were used for immunohistochemical staining. RESULTS The overall PSA recurrence rate was 37.6% for 199 radical prostatectomy cases and 37.9% for 129 with biopsy immunohistochemical staining. Staining of prostatectomies correlated well with PSA recurrence for p53 (p = 0.004) and bcl-2 (p = 0.001). However, biopsy staining did not correlate with prostatectomy staining or PSA recurrence for either marker. CONCLUSIONS The p53 and bcl-2 biomarkers appear to be important to predict recurrence of prostate cancer when prostatectomy specimens are analyzed but this usefulness is not apparent with immunohistochemical staining of prostate biopsies. This difference may reflect sampling error and/or the heterogeneous nature of prostate cancers, and deserves further study.
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Affiliation(s)
- G B Stackhouse
- Department of Surgery, Walter Reed Army Medical Center, Washington, DC, USA
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Abstract
BACKGROUND p21(waf1/cip1) protein is a cyclin-dependent kinase inhibitor able to arrest the cell cycle at the G1 phase by inhibiting DNA replication. The expression of p21(waf1/cip1) and its prognostic value in prostate cancer are largely unexplored. METHODS We used immunohistochemistry to analyze the expression of p21(waf1/cip1) in 213 prostate cancer cases, and the results were related to other known prognostic factors and patient survival during a long-term follow-up. RESULTS The expression of p21 (waf1/cip1) protein was significantly associated with high Gleason score (P = 0.001), DNA aneuploidy (P = 0.013), high S-phase fraction (P = 0.019), and expression of Ki-67 (P = 0.021) and bcl-2 (P = 0.001) as well as cyclin A (P = 0.035) and D proteins (P<0.001). In univariate survival analysis the signal of p21(waf1/cip1) was significantly related to unfavorable prognosis (P = 0.010) both in the entire cohort and in local tumors (P = 0.034). In multivariate analysis, M-category, clinical T-category, Gleason score, and patient age were independent prognostic factors. In local tumors the expression of p21(waf1/cip1) together with clinical T-category and S-phase fraction were significant independent predictors of cancer related survival. CONCLUSIONS The results suggest that the expression of p21(waf1/cip1) protein is associated both with cell proliferation and patient survival in prostate cancer.
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Affiliation(s)
- S Aaltomaa
- Department of Urology, Kuopio University Hospital, Finland
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Affiliation(s)
- C S Foster
- Departments of Pathology, University of Liverpool, UK
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Masuda M, Takano Y, Iki M, Asakura T, Hashiba T, Noguchi S, Hosaka M. Prognostic significance of Ki-67, p53, and Bcl-2 expression in prostate cancer patients with lymph node metastases: a retrospective immunohistochemical analysis. Pathol Int 1998; 48:41-6. [PMID: 9589463 DOI: 10.1111/j.1440-1827.1998.tb03826.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The prognostic significance of Ki-67, p53, and Bcl-2 expression was evaluated in prostate cancer patients with lymph node metastases. Immunohistochemical staining of archived material obtained from 56 patients was performed by the streptavidin-biotin method. Univariate survival analysis showed that a Ki-67 labeling index (Ki-67 LI) of > or = 8.4 in the primary tumor identified a group of patients with a significantly poorer prognosis (P < 0.001). furthermore, a Ki-67 LI of > or = 8.7 in the nodal metastatic tumor was also associated with a poorer prognosis (P < 0.01). Multivariate analysis showed that the Ki-67 LI of primary tumors (P < 0.01) and lymph node metastases (P < 0.01) had independent prognostic value. p53 and Bcl-2 expression had no prognostic value in patients with prostate cancer and lymph node involvement. The Ki-67 LI has more prognostic value than p53 and Bcl-2 expression for patients with prostate cancer that has spread to the lymph nodes.
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Affiliation(s)
- M Masuda
- Department of Urology, Yokohama City University School of Medicine, Japan
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Crundwell M, Arkell D, Gearty J, Phillips S. GENETIC ALTERATIONS IN INCIDENTALLY DIAGNOSED, TRANSITIONAL ZONE PROSTATE CANCER: A SEVEN YEAR FOLLOW-UP. J Urol 1997. [DOI: 10.1016/s0022-5347(01)64281-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M.C. Crundwell
- From the Department of Surgery, University of Birmingham, the Department of Urology, City Hospital NHS Trust, and the Department of Pathology, City Hospital NHS Trust, Birmingham, United Kingdom
| | - D.G. Arkell
- From the Department of Surgery, University of Birmingham, the Department of Urology, City Hospital NHS Trust, and the Department of Pathology, City Hospital NHS Trust, Birmingham, United Kingdom
| | - J. Gearty
- From the Department of Surgery, University of Birmingham, the Department of Urology, City Hospital NHS Trust, and the Department of Pathology, City Hospital NHS Trust, Birmingham, United Kingdom
| | - S.M.A. Phillips
- From the Department of Surgery, University of Birmingham, the Department of Urology, City Hospital NHS Trust, and the Department of Pathology, City Hospital NHS Trust, Birmingham, United Kingdom
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GENETIC ALTERATIONS IN INCIDENTALLY DIAGNOSED, TRANSITIONAL ZONE PROSTATE CANCER. J Urol 1997. [DOI: 10.1097/00005392-199710000-00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grignon DJ, Caplan R, Sarkar FH, Lawton CA, Hammond EH, Pilepich MV, Forman JD, Mesic J, Fu KK, Abrams RA, Pajak TF, Shipley WU, Cox JD. p53 status and prognosis of locally advanced prostatic adenocarcinoma: a study based on RTOG 8610. J Natl Cancer Inst 1997; 89:158-65. [PMID: 8998185 DOI: 10.1093/jnci/89.2.158] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The p53 tumor suppressor gene (also known as TP53) is one of the most frequently mutated genes in human cancer. Several studies have shown that p53 mutations are infrequent in prostate cancer and are associated with advanced disease. PURPOSE We assessed the prognostic value of identifying abnormal p53 protein expression in the tumors of patients with locally advanced prostate cancer who were treated with either external-beam radiation therapy alone or total androgen blockade before and during the radiation therapy. METHODS The study population consisted of a subset of patients entered in Radiation Therapy Oncology Group protocol 8610 ("a phase III trial of Zoladex and flutamide used as cytoreductive agents in locally advanced carcinoma of the prostate treated with definitive radiotherapy"). Immunohistochemical detection of abnormal p53 protein in pretreatment specimens (i.e., needle biopsies or transurethral resections) was achieved by use of the monoclonal anti-p53 antibody DO7; specimens in which 20% or more of the tumor cell nuclei showed positive immunoreactivity were considered to have abnormal p53 protein expression. Associations between p53 protein expression status and the time to local progression, the incidence of distant metastases, progression-free survival, and overall survival were evaluated in univariate (logrank test) and multivariate (Cox proportional hazards model) analyses. Reported P values are two-sided. RESULTS One hundred twenty-nine (27%) of the 471 patients entered in the trial had sufficient tumor material for analysis. Abnormal p53 protein expression was detected in the tumors of 23 (18%) of these 129 patients. Statistically significant associations were found between the presence of abnormal p53 protein expression and increased incidence of distant metastases (P = .04), decreased progression-free survival (P = .03), and decreased overall survival (P = .02); no association was found between abnormal p53 protein expression and the time to local progression (P = .58). These results were independent of the Gleason score and clinical stage. A significant treatment interaction was detected with respect to the development of distant metastases: Among patients receiving both radiation therapy and hormone therapy, those with tumors exhibiting abnormal p53 protein expression experienced a reduced time to the development of distant metastases (P = .001); for patients treated with radiation therapy alone, the time to distant metastases was unrelated to p53 protein expression status (P = .91). CONCLUSIONS Determination of p53 protein expression status yield significant, independent prognostic information concerning the development of distant metastases, progression-free survival, and overall survival for patients with locally advanced prostate cancer who are treated primarily with radiation therapy. IMPLICATIONS The interaction of radiation therapy plus hormone therapy and abnormal p53 protein expression may provide a clinical link to experimental evidence that radiation therapy and/or hormone therapy act, at least in part, by the induction of apoptosis (a cell death program) and suggests that this mechanism may be blocked in patients whose tumors have p53 mutations.
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Affiliation(s)
- D J Grignon
- Wayne State University, Harper Hospital, Detroit, MI 48201, USA
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Cell Proliferation Assessed by Ki-67 Immunoreactivity on Formalin Fixed Tissues is a Predictive Factor for Survival in Prostate Cancer. J Urol 1997. [DOI: 10.1097/00005392-199701000-00067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ansong S. Re: Preoperative reverse transcriptase polymerase chain reaction for prostate specific antigen predicts treatment failure following radical prostatectomy. J Urol 1997; 157:269-70. [PMID: 8976276 DOI: 10.1016/s0022-5347(01)65355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Stattin P, Damber JE, Karlberg L, Bergh A. Cell Proliferation Assessed by Ki-67 Immunoreactivity on Formalin Fixed Tissues is a Predictive Factor for Survival in Prostate Cancer. J Urol 1997. [DOI: 10.1016/s0022-5347(01)65330-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Par Stattin
- Departments of Urology, Andrology and Pathology, Umea University, Umea, and Department of Urology, Central Hospital, Vasteras, Sweden
| | - Jan-Erik Damber
- Departments of Urology, Andrology and Pathology, Umea University, Umea, and Department of Urology, Central Hospital, Vasteras, Sweden
| | - Lars Karlberg
- Departments of Urology, Andrology and Pathology, Umea University, Umea, and Department of Urology, Central Hospital, Vasteras, Sweden
| | - Anders Bergh
- Departments of Urology, Andrology and Pathology, Umea University, Umea, and Department of Urology, Central Hospital, Vasteras, Sweden
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Cher ML, Stephenson RA, James BC, Carroll PR. Cellular Proliferative Fraction of Metastatic Lymph Nodes Predicts Survival in Stage D1 (TxN+MO) Prostate Cancer. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66162-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Michael L. Cher
- Department of Urology, University of California School of Medicine and University of California at San Francisco / Mt. Zion Medical Center, San Francisco, California, and University of Utah School of Medicine, Salt Lake City, Utah
| | - Robert A. Stephenson
- Department of Urology, University of California School of Medicine and University of California at San Francisco / Mt. Zion Medical Center, San Francisco, California, and University of Utah School of Medicine, Salt Lake City, Utah
| | - Brent C. James
- Department of Urology, University of California School of Medicine and University of California at San Francisco / Mt. Zion Medical Center, San Francisco, California, and University of Utah School of Medicine, Salt Lake City, Utah
| | - Peter R. Carroll
- Department of Urology, University of California School of Medicine and University of California at San Francisco / Mt. Zion Medical Center, San Francisco, California, and University of Utah School of Medicine, Salt Lake City, Utah
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Cellular Proliferative Fraction of Metastatic Lymph Nodes Predicts Survival in Stage D1 (TxN+MO) Prostate Cancer. J Urol 1996. [DOI: 10.1097/00005392-199605000-00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bubendorf L, Sauter G, Moch H, Schmid HP, Gasser TC, Jordan P, Mihatsch MJ. Ki67 labelling index: an independent predictor of progression in prostate cancer treated by radical prostatectomy. J Pathol 1996; 178:437-41. [PMID: 8691323 DOI: 10.1002/(sici)1096-9896(199604)178:4<437::aid-path484>3.0.co;2-4] [Citation(s) in RCA: 156] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The clinical course of prostate cancer is highly variable and cannot satisfactorily be predicted by histological criteria alone. Both tumour cell proliferation and neuroendocrine differentiation have been suggested as additional prognostic parameters, neuroendocrine differentiation being considered to enhance tumour cell proliferation. This study investigated the prognostic value of tumour cell proliferation [Ki67 labelling index (LI), MIB 1] and neuroendocrine differentiation and their relationship to each other. One hundred and thirty-seven paraffin-embedded radical prostatectomy specimens were examined. Neuroendocrine differentiation was found in 58 per cent of cases, but was not associated with pTN stage, Gleason score, Ki67 LI, or tumour progression. Ki67 LI was not significantly associated with pTN stage or with Gleason score. High grade (P = 0.0005), advanced local stage (P = 0.0004), positive lymph nodes (P = 0.02), and high Ki67 LI (P = 0.0203) were predictors of tumour progression if univariate analysis was performed, but Cox stepwise regression showed that only advanced local stage (P = 0.0025) and Ki67 LI (P = 0.0105) were independent predictors of tumour progression, the relative risk being 3.6 and 2.5, respectively. It is concluded that Ki67 is an important prognostic marker in prostate cancer with a potential for routine application.
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Affiliation(s)
- L Bubendorf
- Institute for Pathology, University of Basel, Switzerland
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Abstract
p53 protein accumulation in the nuclei of prostatic carcinoma cells, as detected by immunohistochemistry, has been associated with increased cell proliferation rate, increased histologic grade and stage, androgen independence and decreased patient survival. Little is known, however, of p53 in prostatic intraepithelial neoplasia (PIN), the putative precursor proliferation for moderately to poorly differentiated peripheral zone carcinoma of the prostate. In this investigation, we utilized a panel of antibodies reactive with p53 protein to assess p53 protein accumulation in prostatic epithelial hyperplasia, PIN and prostatic carcinoma. Forty patients who had undergone radical prostatectomy were selected for study based on the presence of high grade PIN and carcinoma in the same prostate tissue block. Tissue sections were treated with microwave irradiation for antigen retrieval, and antibodies DO-7, PAb1801 and CM-1 were used for immunohistochemical analysis. An intense signal for immunoreactive p53 was identified in the nuclei of 7/40 (17.5%) clinically-localized prostatic carcinomas. In all 7 cases, high grade PIN also exhibited intense p53 immunoreactivity, whereas only one case of hyperplasia contained immunoreactive p53 protein. These findings support a close relationship between high grade PIN and carcinoma in a subset of primary prostatic carcinomas with high-level p53 protein accumulation.
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Affiliation(s)
- P A Humphrey
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology, Washington University Medical Center, St. Louis, MO, USA
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Vesalainen S, Lipponen P. Expression of retinoblastoma gene (Rb) protein in T12M0 prostatic adenocarcinoma. J Cancer Res Clin Oncol 1995; 121:429-33. [PMID: 7635874 DOI: 10.1007/bf01212951] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The expression of Rb protein was analysed by immunocytochemical methods in 118 patients with T12M0 prostatic adenocarcinoma who were followed-up for more than 12 years. Rb protein was expressed in 117/118 (99%) tumours. The fraction of positive nuclei was (mean +/- SD, 92 +/- 19%) and only one tumour was completely negative for Rb protein. Abnormal expression of the Rb protein (in fewer than 90% of cells) was independent of the T category while there was a significant relationship between DNA ploidy (P = 0.0138), S-phase fraction (P = 0.0042) and expression of the Rb protein. Abnormal expression of the Rb protein had no prognostic value while T category (P = 0.0017), Gleason score (P = 0.0097), DNA ploidy (P = 0.0034), S-phase fraction (P = 0.0179) and mitotic index (P = 0.0001) were significant prognostic factors. In multivariate analysis the only independent predictor was the mitotic index [Risk ratio (RR) (95%CI) = 7.4(2.4-22.5), P = 0.004]. The results show that Rb protein immunohistochemistry has hardly any prognostic significance in prostatic adenocarcinoma whereas direct measurement of cell proliferative activity contains significant prognostic information.
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Affiliation(s)
- S Vesalainen
- Department of Surgery, University of Kuopio, Finland
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Hammond EH, Grignon DJ. Current status of tissue markers as prognostic factors in prostatic adenocarcinoma. Int J Radiat Oncol Biol Phys 1995; 31:419-22. [PMID: 7530701 DOI: 10.1016/0360-3016(94)00582-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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