Microvessel Density as a Predictor of PSA Recurrence After Radical Prostatectomy

Abstract

Whether prostate cancer recurrence can be predicted by microvessel density (MVD) measurements is controversial. One reason for the lack of agreement may be the differing antibodies used to determine MVD. We evaluated MVD using 2 different antibodies against endothelial cells, CD31 and CD34, on 102 patients who underwent radical prostatectomy without adjuvant hormonal therapy. The tumors from these cases were identified, and areas with the highest Gleason pattern were immunostained. Average MVD determined by CD31 (MVD/CD31) staining was significantly lower than that obtained by MVD/CD34 staining (60.1 vs 80.3). By using Kaplan-Meier analysis, prostate-specific antigen (PSA) recurrence was correlated with MVD/CD31 and MVD/CD34. MVD/CD34 and MVD/CD31 were associated strongly with PSA recurrence on a univariate level. However, only MVD/CD34 was an independent predictor of PSA failure. Therefore, some of the confusion about MVD value as a prognostic indicator may be due to the antibodies used.

Comparison of the prognostic potential of hyaluronic acid, hyaluronidase (HYAL‐1), CD44v6 and microvessel density for prostate cancer

“…It has been shown that visualization and scoring of microvessels using anti-CD34 staining are both sensitive and specific. 47,48,54 We therefore used an anti-CD34 MAb to visualize microvessels in PCa tissues. As shown in Figure 1g, MVD was low in the PCa tissue from a nonrecurred patient.…”

“…25,26,41 In addition to their biologic relatedness, each of these histologic markers has shown potential to predict prognosis for PCa patients. 12,19,38,39,[47][48][49][50][51][52] The prognostic capability of HA staining in tumors varies depending on the tissue where the cancer originates. HA staining in Cox proportional hazards model and stepwise selection were used to determine which of the preoperative (i.e., age, PSA and clinical stage) and postoperative (i.e., Gleason sum overall and Ն or Յ 7, EPE, margin and seminal vesicle invasion) parameters and HA, HYAL-1, HA-HYAL-1, MVD and CD44v6 staining inferences had independent prognostic significance.…”

“…47,48,54 Although problems exist in the methods of counting the vessels and in setting a universally accepted cut-off limit for MVD to predict recurrence, MVD has been correlated with Gleason sum, pathologic stage and outcome. [47][48][49] However, other studies have shown that MVD does not correlate with tumor grade, stage and clinical outcome. 50 -52 In our study, MVD at a cut-off limit of 41 showed reasonably high sensitivity at both 72-month (76%) and 112-month (77.8%) follow-up.…”

“…[43][44][45][46] Studies that compared various endothelial cell markers (i.e., CD31, CD34 and factor VIII) have shown that CD34 is a sensitive endothelial cell marker for measuring MVD. 47,48 At the present time, the clinical significance of MVD as an independent predictor of pathologic stage and recurrence in PCa remains unclear. [47][48][49][50][51][52] We compared the prognostic potential of markers HA, CD44v6, HYAL-1 and MVD with regard to clinically localized PCa.…”

“…47,48 At the present time, the clinical significance of MVD as an independent predictor of pathologic stage and recurrence in PCa remains unclear. [47][48][49][50][51][52] We compared the prognostic potential of markers HA, CD44v6, HYAL-1 and MVD with regard to clinically localized PCa. Since HYAL-1 degrades HA and generates angiogenic fragments and CD44 acts as a cell surface receptor for both HA and HA fragments, we examined whether these biologically linked molecules are accurate prognostic indicators for PCa and whether they influence each other's prognostic capability.…”