Histopathological Study of Prostatic Carcinoma in Relation to Gleason Grade, Serum PSA and Ki67 Immunomarker
Keywords:
Adenocarcinoma, Gleason score, immunolabelling index, Ki67, prostate, serum PSA.
Abstract
Introduction- Carcinoma of prostate (CaP) is the second most common cancer in men.Gleason’s score (GS) and pretreatment serum prostate specific antigen (sPSA) levels are important parameters in diagnosis and therapeutic decision making. Recent studies have found that GS tends to undergrade tumors and sPSA levels are not cancer specific. The present study highlights correlation between immunomarker Ki67, GS and sPSA which provides a objective method of grading tumors and helps in better prognostication of patients. Objectives- 1. To study histopathology of prostate carcinoma and its variants and assign them Gleason score as per the Gleason grading system. 2. To study Ki-67 immunoexpression in prostate carcinoma. 3. To correlate Ki-67 expression, Gleason scoring and serum prostate specific antigen levels in prostate carcinoma Methods -A retro-prospective study was done on 100 specimens of prostate carcinoma from the year 2010-2015 in Department of Pathology of ESIC Medical College and PGIMSR, Rajajinagar, Bangalore for a period of 18 months(November2013-April2015).Each case was assigned Gleason score and subjected to immunohistochemistry for Ki67 expression. Results of Ki67 expression was correlated with Gleason score and PSA levels. Results-Out of the 100 cases studied, all case were of acinar/usual adenocarcinoma-WHO type. 40 cases were moderately differentiated, 39 cases were high grade tumors and 21 cases were intermediate grade tumors. Serum PSA levels increased with increase in GS. Ki67 labelling index showed a proportionate increase with increase in GS and serum PSA which was statistically significant. Conclusion- Ki67 is a new emerging biomarker which is significantly associated with tumor grade and pretreatment PSA levels and can be used as an additive parameter or a substitution to known prognostic variables to aid in therapeutic interventions.References
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30) Mesko S, Kupelian P, Demanes DJ, Huang J, Wang PC, Kamrava M. Quantifying the ki-67 heterogeneity profile in prostate cancer. Prostate Cancer.2013:1–5.
31) Verma R, Gupta V, Singh J, Verma M, Gupta G, Gupta S, et al. Significance of p53 and ki-67 expression in prostate cancer. Uroy Ann.2015; 7(4): 488-493.
32) Rugwizangoga B, Vuhahula E, Kitinya J. A Combination Of Ki67 Expression And Gleason Score For Prostatic Adenocarcinoma Offers Better Prognostic Information Than Either Alone. The Internet Journal of Urology. 2014;12(1).1-9.
33) Luczynska E, Gasinska A, Wilk W. Expression of Ki-67 (MIB-1) and GLUT-1 proteins in non-advanced prostatic cancer. Pol J Pathol.2012; 63: 272-277.
34) Cowen D, Troncoso P, Khoo VS, Zagars GK, von Eschenbach AC,Meistrich ML,et al. Ki-67 staining is an independent correlate of biochemical failure in prostate cancer treated with radiotherapy. Clin Cancer Res. 2002 ;8(5):1148-54.
35) Sulik M, Maruszak K, Puchalska J, Misiukiewicz-Poć M. Expression of Ki-67 as a proliferation marker in prostate cancer. Polish Annals of Medicine.2011;18(1):12-19.
36) Zivkovic S. Correlation between prostate-specific antigen and histopathological difference of prostate carcinoma. Arch Oncol .2004; 12(3):148-51.
37) Gurumurthy D, Maggad R, Patel S. Prostate Carcinoma: Correlation of Histopathology with Serum Prostate Specific Antigen. International Journal of Science, Technology and Society. Special Issue: Latest Different Concepts of Gynaecology. 2015;4:p1-5. doi: 10.11648/j.sjcm.s.2015040401.11
38) Anderson-Jackson L, McGrowder DA, Alexander-Lindo R. Prostate specific antigen and gleason score in men with prostate cancer at a private diagnostic radiology centre in Western Jamaica. Asian Pac J Cancer Prev.2012; 13:1453-6.
2) Jain S, Saxena S, Kumar A. Epidemiology of prostate cancer in India. Meta Gene. 2014; 2: 596–605.
3) Ebstein JI. The lower urinary tract and male genital system. In: Kumar V, Abbas AK, Fausto N, Aster JC, editors, Pathologic Basis of Disease. 8th ed. Philadelphia: Elsevier 2010; 976-80.
4) Epstein JI, Netto GN. Biopsy Interpretation of the Prostate. 2nd edn. Lippincott, Williams & Wilkins: Philadelphia, PA, 2008.
5) Rosai J. Male Reproductive system. Rosai and Ackerman’s Surgical Pathology. 10th ed. New Delhi: Reed Elsevier India Private Limited; 2011:1287-1311.
6) Fisher G, Yang ZH, Kudahetti S, Moller H, Scardino P, Cuzick J et al. Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort. Br J Cancer .2013; 108: 271–277.
7) Madani SH, Ameli S, Khazaei S, Kanani M, Izadi B. Frequency of Ki67(MIB-1) and p53 expression among patients with prostate cancer. Indian J of Pathol Microbiol .2011;54:688-91.
8) Verma R, Gupta V, Singh J et al. Significance of p53 and Ki-67 expression in prostate cancer. Urology Annals.2015; 7(4): 488.
9) Diaconescu D, Toma S. Prognostic significance of Mib-1 (Ki-67) expression in prostate cancer and matched lymph node metastases. Bulletin of the Transilvania University of Brasov, Series VI: Medical Sciences.2012; 5(2):65-68.
10) Hamilton W, Sharp DJ, Peters TJ, Round AP. Clinical features of prostate cancer before diagnosis: a population-based case-control study. Br J Gen Pract .2006;56:756–762.
11) Mulholland SG, Stefanelli JL. Genitourinary cancer in the elderly. Am J Kidney Dis. 1990;16(4):324-8.
12) Scott RJr, Mutchnik DL, Laskowski TZ, Schmalhorst WR .Carcinoma of the prostate in elderly men: incidence, growth characteristics and clinical significance. J Urol.1969;101: 602-7.
13) Ojewola RW, Jeje EA, Tijani KH, Ogunjimi MA, Anunobi CC. Clinico–pathological Correlation of Digital Rectal Examination Findings Amongst Nigerian Men with Prostatic Diseases: A Prospective Study of 236 Cases. Niger J Surg. 2013;19:26–31.
14) Haid M, Rabin D, King KM, Feistein CM, Janson KL, Levine SR, et al. Digital rectal examination, serum prostate specific antigen, and prostatic ultrasound: How effective is this diagnostic triad?. J Sur Onc.1994;56:32–38.
15) Babaian RJ, Mettlin C, Kane R, Murphy GP, Lee F, Drago JR,et al. The relationship of prostate‐specific antigen to digital rectal examination and transrectal ultrasonography: Findings of the American cancer society national prostate cancer detection project. Cancer.1992;69(5):1195-1200.
16) Bubendorf L, Schopfer A, Wagner U, Sauter G, Moch H, Willi N,et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol.2000; 31:578–83.
17) Ho CC, Seong PK, Zainuddin ZM, Abdul Manaf MR, Parameswaran M, Razack AH: Retrospective study of predictors of bone metastasis in prostate cancer cases. Asian Pac J Cancer Prev.2013;14:3289–92.
18) Goswami AP, Rupala G, Nutanbala, Goswami N. Serum PSA level in Prostatic lesions with Histopathological correlation in Gujarat. NJIRM .2011; 2(4): 33-8.
19) Albasri A, El-Siddig A, Hussainy A, Mahrous M, Alhosaini AA, Alhujaily A. Histopathologic characterization of prostate diseases in Madinah, Saudi Arabia. Asian Pac J Cancer Prev .2014;15:4175-9.
20) Eble JN, Sauter G, Epstein JI, Sesterhenn IA,editors. Pathology and Genetics of Urinary System and Male Genital Organs. World Health Organization of Tumors. Lyon:IARC Press;2004;7
21) Merrilees AD, Bethwaite PB, Russell GL, et al. Parameters of perineural invasion in radical prostatectomy specimens lack prognostic significance. Mod Pathol. 2008;21:1095-1100.
22) Nelson CP, Dunn RL, Wei JT, Rubin MA, Montie JE, Sanda MG. Contemporary preoperative parameters predict cancer-free survival after radical prostatectomy: A tool to facilitate treatment decisions. Sem Urol Oncol. 2003;21:213–18.
23) Quinn DI, Henshall SM, Brenner PC, et al. Prognostic significance of preoperative factors in localized prostate carcinoma treated with radical prostatectomy. Cancer. 2003;97:1884–93.
24) Bostwick DG, Brawer MK. Prostatic intra-epithelial neoplasia and early invasion in prostate cancer. Cancer. 1987; 15: 788-94.
25) McNeal JE, Bostwick DG. Intraductal dysplasia: A premalignant lesion of the prostate. Hum Pathol.1986; 17:64–71
26) Muñoz E, Gómez F, Paz JI, Casado I, Silva JM, Corcuera MT. Ki-67 immunolabeling in pre-malignant lesions and carcinoma of the prostate. Histological correlation and prognostic evaluation. Eur J Histochem .2003;47(2):123-8.
27) Fisher G, Yang ZH, Kudahetti S, Møller H, Scardino P, Cuzick J, et al. Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort. Br J Cancer.2013;108(2):271-277.
28) Aaltomaa S, Karja V, Lipponen P, et al. Expression of Ki-67, cyclin D1 and apoptosis markers correlated with survival in prostate cancer patients treated by radical prostatectomy.Anticancer Res.2006;26:4873–8.
29) Tsuji M, Murakami Y, Kanayama H, Sano T, Kagawa S. Immunohistochemical analysis of Ki-67 antigen and Bcl-2 protein expression in prostate cancer: effect of neoadjuvant hormonal therapy. Br J Urol.1998;81:116-121.
30) Mesko S, Kupelian P, Demanes DJ, Huang J, Wang PC, Kamrava M. Quantifying the ki-67 heterogeneity profile in prostate cancer. Prostate Cancer.2013:1–5.
31) Verma R, Gupta V, Singh J, Verma M, Gupta G, Gupta S, et al. Significance of p53 and ki-67 expression in prostate cancer. Uroy Ann.2015; 7(4): 488-493.
32) Rugwizangoga B, Vuhahula E, Kitinya J. A Combination Of Ki67 Expression And Gleason Score For Prostatic Adenocarcinoma Offers Better Prognostic Information Than Either Alone. The Internet Journal of Urology. 2014;12(1).1-9.
33) Luczynska E, Gasinska A, Wilk W. Expression of Ki-67 (MIB-1) and GLUT-1 proteins in non-advanced prostatic cancer. Pol J Pathol.2012; 63: 272-277.
34) Cowen D, Troncoso P, Khoo VS, Zagars GK, von Eschenbach AC,Meistrich ML,et al. Ki-67 staining is an independent correlate of biochemical failure in prostate cancer treated with radiotherapy. Clin Cancer Res. 2002 ;8(5):1148-54.
35) Sulik M, Maruszak K, Puchalska J, Misiukiewicz-Poć M. Expression of Ki-67 as a proliferation marker in prostate cancer. Polish Annals of Medicine.2011;18(1):12-19.
36) Zivkovic S. Correlation between prostate-specific antigen and histopathological difference of prostate carcinoma. Arch Oncol .2004; 12(3):148-51.
37) Gurumurthy D, Maggad R, Patel S. Prostate Carcinoma: Correlation of Histopathology with Serum Prostate Specific Antigen. International Journal of Science, Technology and Society. Special Issue: Latest Different Concepts of Gynaecology. 2015;4:p1-5. doi: 10.11648/j.sjcm.s.2015040401.11
38) Anderson-Jackson L, McGrowder DA, Alexander-Lindo R. Prostate specific antigen and gleason score in men with prostate cancer at a private diagnostic radiology centre in Western Jamaica. Asian Pac J Cancer Prev.2012; 13:1453-6.
Published
2018-08-25
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