CD34 immunohistochemical assessment of angiogenesis as a prognostic marker for prostate cancer recurrence after radical prostatectomy.
OBJECTIVE
We assess the neovascularity of clinically localized prostate cancer by immunohistochemistry using the monoclonal antibody CD34 in an attempt to identify associations between angiogenesis and disease progression following radical prostatectomy.


METHODS
Microvascularity was evaluated using the CD34 monoclonal antibody in archival paraffin embedded radical prostatectomy specimens from 149 patients followed from 3 to 10 years (mean 6.6). Vessels were quantified by counting a minimum of 2 selected microscopic fields (200x, 0.754 mm.2) from each tumor, area of prostatic intraepithelial neoplasia and prostatic hyperplasia, and given a numerical value representing the microvessel density count.


RESULTS
Mean microvessel density count did not vary significantly with age or race. There was a significant association between the count and nuclear grade, Gleason sum and pathological stage. Cox survival analysis shows that microvessel density is significantly related to time to recurrence when considered as a continuous variable (p=0.03) as well as dichotomous variable (p=0.007) (microvessel density count less than 90 and 90 or greater). The 5-year recurrence-free survival was significantly higher for patients with a count less than 90 (71%) than for those with a count 90 or greater (51%) (p=0.006). The 5-year recurrence-free survival was also significantly different when microvessel density was used as a continuous variable (p=0.02). Controlling for stage, Gleason sum, race and nuclear grade, microvessel density remained significant in predicting recurrence (p=0.03) but when pretreatment prostate specific antigen was included in the model the count was no longer significant. The microvessel density count in the tumor area significantly increased with increasing Gleason sum and nuclear grade but it did not increase significantly in the adjacent benign prostate or areas of prostatic intraepithelial neoplasia in the same specimen.


CONCLUSIONS
Microvascularity or neovascularity as measured by the CD34 antigen may be a prognostic marker of recurrence for prostate cancer patients after radical prostatectomy but more study in prostate specific antigen era patients with sufficient followup is needed.
Department of Surgery, Walter Reed Army Medical Center, Armed Forces Institute of Pathology, Washington, DC, USA.
M C
MC
Bettencourt
J J
JJ
Bauer
I A
IA
Sesterhenn
R R
RR
Connelly
J W
JW
Moul
D000367:Age Factors; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D044383:Black People; D002467:Cell Nucleus / Q000648:ultrastructure; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000473:pathology; D019048:Prostatic Intraepithelial Neoplasia / Q000098:blood supply / Q000473:pathology; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D044465:White People
D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen