title: Heterogeneity of cathepsin B and stefin A expression in Gleason pattern 3+3 (score 6) prostate cancer needle biopsies.
abstract: BACKGROUND
  There is a significant positive association of increased ratios of cathepsin B to its endogenous inhibitor stefin (cystatin) A in prostatectomy tumors with pelvic lymph node metastases. Needle biopsy diagnosis of prostate cancer is critical in initial treatment selection. The objective was to characterize cathepsin B and stefin A immunostaining patterns in needle biopsies of histologically similar Gleason pattern 3+3 (score 6) foci in relation to pretreatment clinical data.
  
  
  METHODS
  Immunostaining of cathepsin B and stefin A of 65 biopsy sections were imaged, quantified and analyzed with Student's t-test (p < 0.05).
  
  
  RESULTS
  Patients had T1c to T3b clinical stages and pre-surgery total prostate-specific antigen serum levels from 1.25 to 20.0 ng/ml. Cathepsin B and stefin A reaction products were found in the cytoplasm of basal and columnar/cuboidal cells of benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and neoplastic cells. Ratios of cathepsin B to stefin A were significantly higher in prostate cancer when compared to that in BPH and PIN glands.
  
  
  CONCLUSIONS
  Small foci of Gleason pattern 3+3 tumors in needle biopsies have heterogeneous cathepsin B and stefin A immunostaining. Stratification of these tumors in relation to clinical stage by cathepsin B and stefin A may assist in treatment selection.
authors.affiliation: Research Service, VA Medical Center, Minneapolis, MN 55417, USA. sinha001@umn.edu
authors.forename: Akhouri A
authors.initials: AA
authors.lastname: Sinha
authors.forename: Jenifer L
authors.initials: JL
authors.lastname: Morgan
authors.forename: Nada
authors.initials: N
authors.lastname: Wood
authors.forename: Konjit
authors.initials: K
authors.lastname: Betre
authors.forename: Avinash
authors.initials: A
authors.lastname: Reddy
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wilson
authors.forename: Dharam M
authors.initials: DM
authors.lastname: Ramanani
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D002401:Cathepsin B / Q000032:analysis*; D055312:Cystatin A; D015891:Cystatins / Q000032:analysis*; D006801:Humans; D007120:Immunochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology*
chemical_list: D055312:Cystatin A; D015891:Cystatins; D017430:Prostate-Specific Antigen; D002401:Cathepsin B