Prognostic significance of antigenic heterogeneity, gleason grade, and ploidy of lymph node metastases in patients with prostate cancer

Abstract

We retrospectively evaluated 51 prostate cancer patients found to have pelvic lymph node metastases at the time of pelvic lymphadenectomy and 125I implantation. All of them were followed until death or for a minimum of 70 months. Rabbit polyclonal anti‐PSA, anti‐PAP, anti‐PSP‐94, and mouse TURP‐27 monoclonal antibodies were used in immunohis‐tochemical evaluation of the metastatic lesions. In addition, Gleason grade and ploidy were assessed and correlated. No tumor with a Gleason grade of less than 7 could be found in the metastatic lymph nodes. Time to progression (P = 0.003), disease‐specific survival (P = 0.009), and overall survival (P = 0.003) were significantly shorter in patients whose tumors had a primary Gleason pattern of 5 (grade 9 or 10). In the PSA study, patients whose tumors were reactive in more than 75% of cancer cells experienced significantly longer survival than those with less than 75% of cancer cells expressing PSA (P = 0.0006 log rank test). The means of overall survival ± SEM were 71.5 ± 5.0 and 34.9 ± 5.4 months, respectively. Similar correlations were found with disease‐specific survival and time to progression. Patterns of PAP expression and TURP‐27 reactivity were not prognostically useful, whereas PSP‐94 expression may add some additional information. These data suggest that evaluation of tissue PSA heterogeneity in lymph node metastases may offer additional prognostic information on prostate cancer patients. Better prediction of individual prognosis may be possible with the combined use of Gleason grade, flow cytometry, and PSA expression.

Characterization of residual tumor cells following radical radiation therapy for prostatic adenocarcinoma; Immunohistochemical expression of prostate-specific antigen, prostatic acid phosphatase, and cytokeratin 8

“…This finding is in accordance with the observations of Brawer et al [11] in the post-treatment situation, as well as in untreated prostatic tumors, of which the majority have been reported to exhibit a heterogeneous PSA and PAP immunoreactivity [7,12,15,16,29,30,32,34,35,[38][39][40][41].…”

Prostatic carcinoma: a multivariate analysis of prognostic factors

“…Immunohistochemical demonstration of neuroendocrine features (di Sant'Agnese & de Mesy Jensen, 1987;Cohen et al, 1991), c-erbB-2 protein (Gullick et al, 1991;Reilly et al, 1991;Hale et al, 1992), p53 protein (Porter et al, 1992), prostate acid phosphatase (PAP) (Sakai et al, 1991), prostate-specific antigen (PSA) (Hammond et al, 1989;Bazinet et al, 1992) and vimentin (Leong et al, 1988) has been related to tumour prognosis. However, at present there is no general agreement concerning the best combination of prognostic factors.…”

Hormone resistant prostatic adenocarcinoma. An evaluation of prognostic factors in pre- and post-treatment specimens

“…Immunohistochemical demonstration of neuroendocrine differentiation (di Sant 'Agnese & de Mesy Jensen, 1987;Cohen et al, 1991), c-erbB-2 protein (Gullick et al, 1991;Reilly et al, 1991;Hale et al, 1992), p53 protein (Porter et al, 1992) and PSA (Hammond et al, 1989;Bazinet et al, 1992) have also been related to tumour growth.…”