Comparison of proliferating cell nuclear antigen immunostaining in lymph node metastases and primary prostate adenocarcinoma after neoadjuvant androgen deprivation therapy.
OBJECTIVE
To evaluate the effect of neoadjuvant androgen deprivation therapy (NADT) on the cellular proliferative activity in primary prostate cancer and lymph node metastases using proliferating cell nuclear antigen (PCNA) immunostaining.


METHODS
Metastatic pelvic lymph nodes and tumoral prostatic tissue were obtained from 21 patients after radical prostatectomy and pelvic lymphadenectomy. Sixteen patients received NADT for 3 months prior to surgery; five patients did not and were evaluated as a control group. Histopathologic analysis was performed using PCNA immunostaining. and histopathologic findings of primary tumors and lymph node metastases after NADT were reported. Clinical follow-up was performed for a mean of 43.7 months.


RESULTS
Evaluation of PCNA immunostaining of lymph node metastases in the 16 treated patients revealed a mean positivity for metastatic tumor of 4.5% (SD 3.1%); the corresponding value for the five patients who were not treated with NADT was 19.6% (SD 0.94%) (p < 0.05). In four of the treated cases the proliferative activity in the lymph node metastases was greater than that in the other 12 (9.3% and 3.0%, respectively) and no histopathologic regressive changes were observed in these four cases. The residual tumoral proliferative activity in lymph nodes was greater than that in primary tumors (4.5% and 1.3%, respectively).


CONCLUSIONS
This study shows that the nodal metastases were responsive to hormonal therapy, as assessed by PCNA staining, although a greater residual proliferative activity was observed after NADT in lymph node metastases in comparison with the primary prostatic tumor. This can be attributed to a metastatic phenotype less responsive to hormonal therapy compared to the primary tumor.
Minardi
Daniele
D
Institute of Urology, University of Ancona Medical School, Ancona, Italy.
Galosi
Andrea B
AB
Giannulis
Ioannis
I
Montironi
Rodolfo
R
Polito
Mario
M
Muzzonigro
Giovanni
G
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000032:analysis; D016022:Case-Control Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D016896:Treatment Outcome
D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; D018809:Proliferating Cell Nuclear Antigen