Prostate biopsies from black men express higher levels of aggressive disease biomarkers than prostate biopsies from white men

Abstract

A wide array of biomarkers is being investigated as predictors of prostate cancer (PCa) diagnosis and recurrence. We compared the expression of a small panel of these biomarkers as a function of race among men undergoing radical prostatectomy (RP). Prostate needle biopsy specimens from 131 patients treated with RP at the Durham Veterans Affairs Medical Center were hematoxylin and eosin stained and immunofluorescent assayed for α-methylacyl CoA racemase (AMACR), androgen receptor (AR) and Ki67. Proprietary image analysis was used to identify six biometric feature combinations that were significantly associated with progression in a previous study. Analysis of population characteristics, stratified by race, was performed using rank-sum and χ(2)-test. The effect of race on expression of these biomarker profiles was analyzed using multivariate linear regression. All six biomarker features were expressed at higher levels in black men than white men, with Norm AR (P=0.006) and Ki67 (P=0.02) attaining statistical significance. On multivariate analysis, all markers were expressed at higher levels in black men, with Norm AR (P=0.001), Ki67 (P=0.007) and Ki67/lum (P=0.022) reaching significance. These data support the hypothesis that PCa may be biologically more aggressive among black men.

Controversial predictors of biochemical recurrence after radical prostatectomy: a study from a Latin American (Brazilian) Institution

“…Prostate cancer may be biologically more aggressive among Black men though controversial (7)(8)(9). In a study by Cross et al (10), even though African-American men presented at a younger age and with more advanced disease compared with White men with prostate cancer, PSA outcome after RP when controlled for known clinical predictive factors was not statistically different.…”

“…Prostate cancer may be biologically more aggressive among Black men though controversial (7)(8)(9)(10)(11). The prevalence of prostate cancer in Brazil is higher in Black men compared to White men (12)(13)(14)(15).…”

Re-Examining Racial Disparities in Prostate Cancer Outcomes

“…Of note, recent studies have identified different expression levels of prostate cancer-related genes between African American and white men, even after adjustment for clinical parameters. 12,13 Finally, a lower threshold for intervention might be appropriate for African American men initially opting for active surveillance. Decisions for intervention should also be informed by the fact that from a psychological standpoint, African American men experience substantially greater traumatic stress symptoms after prostate cancer diagnosis than…”

A Population-Based Study of Men With Low-Volume Low-Risk Prostate Cancer: Does African-American Race Predict for More Aggressive Disease?

“…One study by Kim et al on 131 men treated at the Durham Veterans Medical Center found that AA men had higher levels of androgen receptor and Ki-67 biomarkers, suggesting that that the tumors in AA men are biologically more aggressive. 26 Other studies have shown a higher level of androgen receptor, 27 epidermal growth factor, 28 and metastasis-associated protein 1 29 in AA men. A recent microarray-based study that compared AA men with CA men found 95 genes overexpressed specifically in AA men and 132 genes in CA men, further suggestive of significant genetic differences in prostate cancer between the 2 races.…”