title: Optimized microvessel density analysis improves prediction of cancer stage from prostate needle biopsies.
abstract: OBJECTIVE
  Clinical staging of prostate cancer is inaccurate, often with significant upstaging on final pathologic review. We previously demonstrated the ability to predict extraprostatic extension of cancer by use of the Gleason score and serum prostate-specific antigen (PSA) measurements. Herein we present an interim analysis of data from an ongoing multi-institutional study to determine the predictive power of an enhancement of microvessel density analysis in combination with Gleason score and serum PSA to predict extraprostatic extension.
  
  
  METHODS
  We evaluated a total of 186 randomly selected biopsy samples and matched totally embedded radical prostatectomy samples with preoperative PSA concentrations and patient demographics. Gleason score and optimized microvessel density (OMVD) were determined from the needle biopsy samples; pathologic stage was verified by independent review of the radical prostatectomy samples. An automated digital image analysis system measured microvessel morphology and calculated the OMVD in the biopsy samples (Biostage; Bard Diagnostic Sciences, Seattle, Wash).
  
  
  RESULTS
  Prediction of extraprostatic extension was increased significantly when OMVD analysis was added to Gleason score and serum PSA concentration (P = 0.003).
  
  
  CONCLUSIONS
  Optimized microvessel density analysis significantly increases the ability to predict extraprostatic extension of cancer preoperatively when combined with Gleason score and serum PSA concentration. This method appears to be a useful tool that can assist with treatment decisions in selected patients.
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Bostwick
authors.forename: T M
authors.initials: TM
authors.lastname: Wheeler
authors.forename: M
authors.initials: M
authors.lastname: Blute
authors.forename: D M
authors.initials: DM
authors.lastname: Barrett
authors.forename: G T
authors.initials: GT
authors.lastname: MacLennan
authors.forename: T J
authors.initials: TJ
authors.lastname: Sebo
authors.forename: P T
authors.initials: PT
authors.lastname: Scardino
authors.forename: P A
authors.initials: PA
authors.lastname: Humphrey
authors.forename: M A
authors.initials: MA
authors.lastname: Hudson
authors.forename: Y
authors.initials: Y
authors.lastname: Fradet
authors.forename: G J
authors.initials: GJ
authors.lastname: Miller
authors.forename: E D
authors.initials: ED
authors.lastname: Crawford
authors.forename: B A
authors.initials: BA
authors.lastname: Blumenstein
authors.forename: H E
authors.initials: HE
authors.lastname: Mahran
authors.forename: B J
authors.initials: BJ
authors.lastname: Miles
mesh_terms: D000368:Aged; D000465:Algorithms; D001707:Biopsy, Needle; D002196:Capillaries; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000098:blood supply* / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen