Introduction: The search for prognostic molecular markers in prostatic carcinoma is still ongoing. The present study was carried out to determine the degree of expression of periostin and P-cadherin by immunohistochemistry as well as nuclear morphometry as a predictor of clinical behavior in prostatic intraepithelial neoplasia (PIN) and prostatic carcinoma cases.
Materials and methods: A total of 70 patients with prostatic lesions (20 patients with PIN, 40 patients with prostatic adenocarcinoma, and 10 cases patients with non-neoplastic prostatic inflammatory lesions as controls) from 2004 to 2009 who had not received radiation, hormonal therapy, or chemotherapy before surgery were studied. Representative tumor sections were stained immunohistochemically with antibodies against periostin and P-cadherin, and assessed semiquantitatively. The Gleason score and pathological tumor stage were recorded. The relationship between the expression of these proteins and clinicopathological parameters such as tumor nuclear grade, pathological stage, Gleason's score, and lymph node invasion was studied. All variables were correlated with clinical progression and disease-specific survival on univariate and multivariate analyses.
Results: A statistically highly significant inverse relationship (P<0.01) was found between reduced P-cadherin expression and tumor stage and lymph node invasion. A statistically significant direct relationship (P<0.05) was found between periostin expression on the one hand and tumor grade and tumor stage on the other.
Conclusion: Reduced P-cadherin and increased periostin expression are independent predictors of poor outcome in patients with PIN and prostate cancer. Moreover, increased nuclear area yields additional information in predicting a poor clinical outcome, especially in patients with PIN lesions. Thus, this study highlighted the role of periostin and P-cadherin immunoreactivity in the progression of prostate PIN and carcinoma; they may be valuable prognostic parameters in prostate cancer and their associated expression may provide an additional prognostic advantage for undetermined cases with high potential. These tissue markers may help identify patients' clinical outcome and may benefit from adjuvant therapy.
|
