The proliferation marker Ki67, but not neuroendocrine expression, is an independent factor in the prediction of prognosis of primary prostate cancer patients.
BACKGROUND
Neuroendocrine markers, which could indicate for aggressive variants of prostate cancer and Ki67 (a well-known marker in oncology for defining tumor proliferation), have already been associated with clinical outcome in prostate cancer. The aim of this study was to investigate the prognostic value of those markers in primary prostate cancer patients.


METHODS
NSE (neuron specific enolase), ChrA (chromogranin A), Syp (Synaptophysin) and Ki67 staining were performed by immunohistochemistry. Then, the prognostic impact of their expression on overall survival was investigated in 166 primary prostate cancer patients by univariate and multivariate analyses.


RESULTS
NSE, ChrA, Syp and Ki67 were positive in 50, 45, 54 and 146 out of 166 patients, respectively. In Kaplan-Meier analysis only diffuse NSE staining (negative vs diffuse, p = 0.004) and Ki67 (≤ 10% vs > 10%, p < 0.0001) were significantly associated with overall survival. Ki67 expression, but not NSE, resulted as an independent prognostic factor for overall survival in multivariate analysis.


CONCLUSIONS
A prognostic model incorporating Ki67 expression with clinical-pathological covariates could provide additional prognostic information. Ki67 may thus improve prediction of prostate cancer outcome based on standard clinical-pathological parameters improving prognosis and management of prostate cancer patients.
Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
Mariarosa
M
Pascale
Department of Medical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy.
Cinzia
C
Aversa
Department of Medical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy.
Renzo
R
Barbazza
Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
Barbara
B
Marongiu
Department of Medical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy.
Salvatore
S
Siracusano
Department of Urology, Ospedale San Giovanni, Bellinzona, Switzerland.
Flavio
F
Stoffel
Department of Laboratory Medicine, S.C. Pathology, Santa Maria degli Angeli Hospital, Pordenone, Italy.
Sando
S
Sulfaro
Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
Enrico
E
Roggero
Department of Medical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy.
Serena
S
Bonin
Department of Medical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy.
Giorgio
G
Stanta
Ki67; NSE; primary prostate cancer; prognosis
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