1475 EVIDENCE FOR A CELL CYCLE PROLIFERATION “FIELD EFFECT” IN PROSTATE CANCER (2013)

You have accessJournal of UrologyProstate Cancer: Detection & Screening (II)1 Apr 20131475 EVIDENCE FOR A CELL CYCLE PROLIFERATION "FIELD EFFECT" IN PROSTATE CANCER Filipe Carvalho, William Welbourn, Julia Reid, Elizabeth Humphreys, Misop Han, Jerry Lanchbury, Alexander Gutin, Steven Stone, and David Berman Filipe CarvalhoFilipe Carvalho Baltimore, MD , William WelbournWilliam Welbourn Salt Lake City, UT , Julia ReidJulia Reid Salt Lake City, UT , Elizabeth HumphreysElizabeth Humphreys Baltimore, MD , Misop HanMisop Han Baltimore, MD , Jerry LanchburyJerry Lanchbury Salt Lake City, UT , Alexander GutinAlexander Gutin Salt Lake City, UT , Steven StoneSteven Stone Salt Lake City, UT , and David BermanDavid Berman Kingston, Canada View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2940AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In men newly diagnosed with prostate cancer (CaP), discriminating between men who will and will not benefit from definitive therapy is often a challenge. Gleason grading provides a strong predictor of risk, but due to sampling issues, diagnostic biopsies often misclassify patients. A classifier that was less affected by sampling error could improve risk assessment in biopsies. High expression of cell cycle proliferation genes (CCP) has been correlated with high risk of CaP-specific mortality. To address the potential utility of CCP assays in overcoming sampling error, we measured CCP in prostate tumors and in cancer-free prostate tissues at various distances from the index tumor. METHODS Under an institutionally approved protocol, 35 entirely submitted radical prostatectomy specimens (2001-2011) with unilateral CaP were selected. Patients with prior hormone therapy were excluded. Gleason score (2005 ISUP criteria), stage, and margin status were reviewed by a urologic pathologist. Median preoperative PSA was 5.2. Gleason scores were <7 (n=17), 7 (n=13) or >7 (n=5). Pathologic stage was pT2 (n=28) and pT3a (n=7). Margins were negative in all but 3 cases. Unstained archival specimens were analyzed in tumor samples and in benign tissues at 3 distances from the tumor: 3mm and 10mm (ipsilateral), and more than 20mm (contralateral). CCP scores were generated as in previous studies. RESULTS For tumors, CCP scores varied from -1.7 to +3. These values corresponded to the lowest and highest risk categories found in previous studies, respectively. The average tumor CCP score was -0.05. CCP scores in benign regions correlated with Tumor CCP score (R=0.46-0.67; p=0.0013 ? 8.9 × 10E-6). Interestingly, the correlation improved when we compared the CCP score from the average of tumor and benign adjacent to the average of benign near and contralateral (R= 0.77). CCP values in benign prostate tissue declined slightly with increasing distance from cancer, losing, on average, only 0.08 units at each successively distant site. CONCLUSIONS We found a striking correlation between CCP in CaP tissues and in benign tissue in other regions of the same prostate. These findings suggest that prognostic CCP scores could be generated from needle biopsies containing few cancer glands. If the correlation is confirmed by further studies, CCP analysis could also aid in choosing a second biopsy in patients with a negative initial biopsy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e605 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Filipe Carvalho Baltimore, MD More articles by this author William Welbourn Salt Lake City, UT More articles by this author Julia Reid Salt Lake City, UT More articles by this author Elizabeth Humphreys Baltimore, MD More articles by this author Misop Han Baltimore, MD More articles by this author Jerry Lanchbury Salt Lake City, UT More articles by this author Alexander Gutin Salt Lake City, UT More articles by this author Steven Stone Salt Lake City, UT More articles by this author David Berman Kingston, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...