| Abstract: |
Background: The natural history of prostate cancer is highly variable and difficult to predict. We report on the prognostic value of phosphatase and tensin homologue (PTEN) loss in a cohort of 675 men with conservatively managed prostate cancer diagnosed by transurethral resection of the prostate. Methods: The PTEN status was assayed by immunohistochemistry (PTEN IHC) and fluorescent in situ hybridisation (PTEN FISH). The primary end point was death from prostate cancer. Results: The PTEN IHC loss was observed in 18% cases. This was significantly associated with prostate cancer death in univariate analysis (hazard ratio (HR)=3.51; 95% CI 2.60-4.73; P=3.1×10-14). It was highly predictive of prostate cancer death in the 50% of patients with a low risk score based on Gleason score, PSA, Ki-67 and extent of disease (HR=7.4; 95% CI 2.2-24.6; P=0.012)), but had no prognostic value in the higher risk patients. The PTEN FISH loss was only weakly associated with PTEN IHC loss (k=0.5). Both PTEN FISH loss and amplification were univariately predictive of death from prostate cancer, but this was not maintained in the multivariate analyses. Conclusion: In low-risk patients, PTEN IHC loss adds prognostic value to Gleason score, PSA, Ki-67 and extent of disease. © 2013 Cancer Research UK. All rights reserved. |
| Keywords: |
immunohistochemistry; adult; human tissue; aged; middle aged; major clinical study; cancer localization; cancer recurrence; adenocarcinoma; ki 67 antigen; ki-67 antigen; prostate specific antigen; in situ hybridization, fluorescence; tumor markers, biological; cancer mortality; high risk patient; prostate cancer; gleason score; prostate-specific antigen; prostatic neoplasms; gene expression regulation, neoplastic; fluorescence in situ hybridization; needle biopsy; phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase; pten phosphohydrolase; predictive value of tests; prostate adenocarcinoma; gene silencing; transurethral resection; predictive value; transurethral resection of prostate; cancer prognosis; neoplasm grading; low risk population
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