التفاصيل البيبلوغرافية
| العنوان: |
Androgen receptor expression is associated with prostate cancer-specific survival in castrate patients with metastatic disease. |
| المؤلفون: |
Donovan, Michael J.1 michael.donovan@aureon.com, Osman, Iman2, Khan, Faisal M.1, Vengrenyuk, Yevgen1, Capodieci, Paola1, Koscuiszka, Michael3, Anand, Aseem3, Cordon-Cardo, Carlos1,4, Costa, Jose1,5, Scher, Howard I.3 |
| المصدر: |
BJU International. Feb2010, Vol. 105 Issue 4, p462-467. 6p. 2 Color Photographs, 2 Charts, 1 Graph. |
| مصطلحات موضوعية: |
*ANDROGENS, *PROSTATE cancer, *IMMUNOFLUORESCENCE, *METASTASIS, *PROSTATE-specific antigen, *TUMORS |
| مستخلص: |
Study Type – Aetiology (case series) Level of Evidence 4 OBJECTIVE To investigate whether baseline (before treatment) clinical variables and tumour specimen characteristics (including the androgen receptor, AR) from patients with castrate-resistant metastatic prostate cancer can be used to predict the time to prostate cancer-specific mortality and overall survival, as AR levels in prostate cancer have been associated with disease progression, including prostate-specific antigen (PSA) recurrence and systemic metastasis. PATIENTS AND METHODS Haematoxylin and eosin (H&E) slides/blocks and outcome data from a 104 castrate patients with metastatic disease (43 prostatectomy and 61 prostate needle biopsy samples), were independently reviewed; H&E morphometry and quantitative immunofluorescence were used to assess the samples. Sections were analysed with a multiplex quantitative immunofluorescence (IF) assay for cytokeratin-18 (epithelial cells), 4′,6-diamidino-2-phenylindole (nuclei), p63/high molecular weight keratin (basal cells), AR and α-methyl CoA-racemase. Images were acquired with spectral imaging software and processed for quantification with IF algorithms. RESULTS The median follow-up was 12 years from diagnosis; 49 men (47%) baseline PSA levels of ≥ 20 ng/mL, 55 (53%) had a Gleason sum of 8, 63 (60%) died from the disease and 40% were alive (censored). In all, 66 patients had evaluable IF features, and the association with outcome was evaluated by univariate Cox modelling and support-vector regression. PSA was the only clinical variable associated with outcome (concordance index, CoI, 0.41; P < 0.05, log-rank test). The amount of AR present within tumour nuclei (regardless of tissue provenance and primary treatment) significantly correlated with a greater risk of a shorter time to prostate cancer-specific mortality (CoI 0.36; P < 0.05 log-rank test). There were no H&E features that correlated with mortality. CONCLUSION By univariate analysis, increased nuclear AR expression in either the diagnostic biopsy and/or radical prostatectomy specimen, from patients with advanced disease, was associated with a reduced time to prostate cancer-specific mortality. [ABSTRACT FROM AUTHOR] |
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