Can molecular markers stratify the diagnostic value of high-grade prostatic intraepithelial neoplasia?
Autor: | Tobias Eichenberger, Lukas Bubendorf, Gieri Cathomas, Jürg Vosbeck, Inti Zlobec, Tobias Zellweger, Thomas C. Gasser, Seife Hailemariam, Alex Bachmann, Gianfranco Mattarelli |
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Rok vydání: | 2010 |
Předmět: |
PCA3
Male medicine.medical_specialty Pathology Population Urology Racemases and Epimerases Risk Assessment Pathology and Forensic Medicine Diagnostic Techniques Endocrine Prostate cancer Prostate Biopsy medicine Biomarkers Tumor Humans High-grade prostatic intraepithelial neoplasia education Annexin A2 Retrospective Studies Prostatic Intraepithelial Neoplasia Intraepithelial neoplasia education.field_of_study medicine.diagnostic_test Staining and Labeling business.industry Cancer Prostatic Neoplasms Prostate-Specific Antigen medicine.disease Immunohistochemistry medicine.anatomical_structure Ki-67 Antigen Proto-Oncogene Proteins c-bcl-2 business |
Zdroj: | Human pathology. 42(5) |
ISSN: | 1532-8392 |
Popis: | The diagnostic performance of isolated high-grade prostatic intraepithelial neoplasia in prostatic biopsies has recently been questioned, and molecular analysis of high-grade prostatic intraepithelial neoplasia has been proposed for improved prediction of prostate cancer. Here, we retrospectively studied the value of isolated high-grade prostatic intraepithelial neoplasia and the immunohistochemical markers ?-methylacyl coenzyme A racemase, Bcl-2, annexin II, and Ki-67 for better risk stratification of high-grade prostatic intraepithelial neoplasia in our local Swiss population. From an initial 165 diagnoses of isolated high-grade prostatic intraepithelial neoplasia, we refuted 61 (37%) after consensus expert review. We used 30 reviewed high-grade prostatic intraepithelial neoplasia cases with simultaneous biopsy prostate cancer as positive controls. Rebiopsies were performed in 66 patients with isolated high-grade prostatic intraepithelial neoplasia, and the median time interval between initial and repeat biopsy was 3 months. Twenty (30%) of the rebiopsies were positive for prostate cancer, and 10 (15%) showed persistent isolated high-grade prostatic intraepithelial neoplasia. Another 2 (3%) of the 66 patients were diagnosed with prostate cancer in a second rebiopsy. Mean prostate-specific antigen serum levels did not significantly differ between the 22 patients with prostate cancer and the 44 without prostate cancer in rebiopsies, and the 30 positive control patients, respectively (median values, 8.1, 7.7, and 8.8 ng/mL). None of the immunohistochemical markers, including ?-methylacyl coenzyme A racemase, Bcl-2, annexin II, and Ki-67, revealed a statistically significant association with the risk of prostate cancer in repeat biopsies. Taken together, the 33% risk of being diagnosed with prostate cancer after a diagnosis of high-grade prostatic intraepithelial neoplasia justifies rebiopsy, at least in our not systematically prostate-specific antigen-screened population. There is not enough evidence that immunohistochemical markers can reproducibly stratify the risk of prostate cancer after a diagnosis of isolated high-grade prostatic intraepithelial neoplasia. |
Databáze: | OpenAIRE |
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