Progression and survival in prostatic adenocarcinoma: a comparison of clinical stage, Gleason grade, S-phase fraction and DNA ploidy

Vesalainen, S; Nordling, Stig; Lipponen, P; Talja, Martti; Syrjänen, Karí

doi:10.1038/bjc.1994.298

Cited by 26 publications

(32 citation statements)

References 31 publications

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“…These results suggest that tumours with reduced α-catenin expression rapidly progress locally into invasive disease. It is obvious that the metastatic potential of prostate tumours is not dependent on cell adhesion factors alone, and many other factors including the host response are involved (Vesalainen et al, 1994). In alignment with our notion, the relationship between α-catenin expression and tumour spread has been reported previously in prostate cancer (Richmond et al, 1997) and in tumours of the urinary tract (Shimazui et al, 1996).…”

Section: Discussionsupporting

confidence: 74%

“…The volume corrected mitotic index method (M/V index) was used, which expresses the number of mitotic figures/square millimetre of tumour tissue in the section (Vesalainen et al, 1995). The results of flow cytometry have been reported in detail previously (Vesalainen et al, 1994). DNA index was available in 182/215 (85%) of cases and S phase fraction in 175/215 (81%) of cases.…”

Section: Histological Methods and Flow Cytometrymentioning

confidence: 99%

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α-Catenin expression has prognostic value in local and locally advanced prostate cancer

et al. 1999

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Normally functioning cell–cell adhesion plays an important role in the maintenance of tissue architecture and cell cohesion. E-cadherin is an important adhesion molecule of epithelial cells. In many types of cancer the expression of E-cadherin is reduced leading to increased risk of disease progression. α-Catenin is one of the intracellular elements of the E-cadherin–catenin complex. The abnormalities in the expression of α-catenin seem to associate with malignant cellular features and disease progression in prostate cancer. To further analyse the significance of α-catenin expression, we studied 215 cases of prostate cancer by immunohistochemistry and the results were related to other known prognostic factors and patient survival during a mean follow-up period of 13 years. α-Catenin expression was down-regulated in 19% of the cases and 3% of the tumours were totally α-catenin-negative. The abnormal α-catenin expression and cytoplasmic signal were significantly linked with high T-category, metastatic disease, high Gleason score, perineural growth, high mitotic rate, high S phase fraction and DNA aneuploidy ( P < 0.05 for all). In the survival analysis, reduced α-catenin expression ( P = 0.06) and cytoplasmic signal ( P = 0.04) were related to unfavourable patient outcome. In the multivariate analysis, including TM-classification and Gleason score, α-catenin expression had independent prognostic value in T1–2 M0 tumors. In the M0 tumours, abnormal α-catenin signal was independently associated with recurrence-free survival as well. The results indicate that down-regulation of α-catenin is related to several malignant cellular features, and it seems to have prognostic significance in the early phases of cancer progression. We suggest that α-catenin expression can provide prognostic information in early prostate cancer. © 1999 Cancer Research Campaign

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Section: Discussionsupporting

confidence: 74%

Section: Histological Methods and Flow Cytometrymentioning

confidence: 99%

α-Catenin expression has prognostic value in local and locally advanced prostate cancer

et al. 1999

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“…The increase in AR in low-grade tumors as measured by immunohistochemistry is not quantitative and is a better measure of percentage 29 rather than intensity of staining. The fact that AR density is related to S-phase fraction, which has been shown in prior studies [32][33][34][35][36] to be associated with poor prognostic features and outcome, may indicate that the significance of AR density may be different from that of the percentage of AR-positive cells. For example, the amount of ARs per cell may be increased due to the presence of nonfunctioning AR with upregulation, a mutation leading to sensitivity of AR to other substrates or simply increased AR due to androgenic stimulation leading to more division.…”

Section: Discussionmentioning

confidence: 99%

“…22 The additional advantage to this technique is the ability to measure S-phase fraction and ploidy , which have been found to have prognostic value in several publications. [32][33][34][35][36] ARs may stimulate proliferation through their mechanism of action. However, it is not known whether high AR density correlates with a higher S-phase fraction, with its adverse prognostic implications.…”

Section: Introductionmentioning

confidence: 99%

Androgen receptor antigen density and S-phase fraction in prostate cancer: a pilot study

Abdel‐Wahab

Krishan

Milikowski

et al. 2003

Prostate Cancer Prostatic Dis

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Purpose: To determine whether quantitative flow cytometric androgen receptor density expression (MFC ratio) in prostate cancer was associated with S-phase fraction. Methods: Flow cytometry was performed to determine DNA aneuploidy, S-phase fraction, percentage of androgen receptor (AR)-positive cells, and MFC ratio in prostate cancer patients. Results: MFC ratio showed distinct clustering. Eight patients had a low MFC ratio of 1.78-2.74, while 10 patients had high MFC ratios between 4.99 and 6.48. The Sphase fraction had average values of 11.05 vs 4.92 in tumors with high vs low MFC ratio (Po0.01). Conclusion: S-phase fraction was significantly higher in tumors with high AR density.

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“…• 8 level 1b studies reported a significant correlation of DNAcytometric features with histologically proven cancer spread beyond the capsule as detected after radical prostatectomy [167][168][169][170][171][172][173][174]. 4 of them document a significant improvement of diagnostic accuracy concerning the prediction of organ confinement by DNA-ploidy features over Gleason-score alone ( Table 3).…”

Section: Methodologically Sufficient Papersmentioning

confidence: 99%

DNA-cytometric grading of prostate cancer Systematic review with descriptive data analysis

Böcking¹,

Tils²,

Schramm³

et al. 2014

Pathol Discov

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Gleason-score <=6, assessed on core needle biopsies, is an essential prognostic parameter to offer the strategy of Active Surveillance (AS) to patients with locally confined cancers of the prostate. Yet, its interobserver reproducibility is low (48-70%) and its prognostic validity unsatisfactory. An option to complementary assess the malignant potential of these cancers are objective DNA-ploidy-measurements on existing biopsies. For that purpose chromosomal heterogeneity is indirectly quantified by DNA-cytometry resulting in DNA-grades of malignancy 1-4. This review systematically trawls and evaluates all scientific publications on the potential diagnostic and prognostic validity and the heterogeneity of DNA-ploidy measurements in cancers of the prostate between 1966 and 2013. Publications have been classified into Oxford levels of evidence and levels of significance were given for the correlation of DNA-ploidy with different clinical outcomes. 114 scientific articles had to be excluded because of different methodological reasons. All but one of the 67 methodologically acceptable articles report on a significant diagnostic resp. prognostic significance of DNA ploidy measurements in cancers of the prostate. 8 level 1b studies report that DNA-ploidy, assessed on punch biopsies independently predicts organ confinement as assessed after radical prostatectomy. 18 level 2b studies prove that DNA-ploidy measurements add statistically significant information to the Gleason-score. 16 level 2b investigations report a significant correlation of DNA-ploidy with recurrence-free survival. 15 level 2b studies document a significant correlation with overall survival after different types of therapy. 5 level 2b investigations prove a significant correlation with local recurrence or progress after radical prostatectomy. 3 level 2b publications show a significant correlation of DNAploidy with the occurrence of lymph node-or bone metastases after radical prostatectomy. 1 level 2b study documents the additional prognostic value of DNA-ploidy measurements over conventional subjective grading in prostate cancer patients under AS. All existing 15 narrative reviews on selected articles dealing with prognostic DNA-cytometry in cancers of the prostate are in favor of this method. Prospective level 1b studies, especially those proving the validity of DNA ploidy measurements to predict non-progression in patients with clinically insignificant low-grade low stage cancers of the prostate eligible for Active Surveillance additionally to the Gleason-score are still missing.

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Progression and survival in prostatic adenocarcinoma: a comparison of clinical stage, Gleason grade, S-phase fraction and DNA ploidy

Cited by 26 publications

References 31 publications

α-Catenin expression has prognostic value in local and locally advanced prostate cancer

α-Catenin expression has prognostic value in local and locally advanced prostate cancer

Androgen receptor antigen density and S-phase fraction in prostate cancer: a pilot study

DNA-cytometric grading of prostate cancer Systematic review with descriptive data analysis

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