title: Two-dimensional neovascular complexity is significantly higher in nontumor prostate tissue than in low-risk prostate cancer.
abstract: OBJECTIVE
  Prostate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkers with improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexity in prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlations between the results and selected clinical and pathological parameters of prostate carcinoma.
  
  
  METHODS
  A total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostate cancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsy sampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-µm sections were treated with CD34 antibodies and were digitized by using an image analysis system that automatically estimates the surface fractal dimension.
  
  
  RESULTS
  Our results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlations were found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathological stage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence.
  
  
  CONCLUSIONS
  The value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancer tissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmark of intermediate- and high-risk prostate cancer.
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Taverna
authors.affiliation: Department of Inflammation and Immunology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Grizzi
authors.affiliation: Department of Pathology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Colombo
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Seveso
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Giusti
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Proietti
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Fiorini
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Casale
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Buffi
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzari
authors.affiliation: Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D017709:Fractals; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007610:Kallikreins / Q000097:blood; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Biological markers; Blood vessels; Neoplasms; Prostate