Urotensin II Receptor Predicts the Clinical Outcome of Prostate Cancer Patients and Is Involved in the Regulation of Motility of Prostate Adenocarcinoma Cells
Discrepancy between the Gleason score on needle biopsy and the grading of prostatectomy specimens is common and universal. Inaccuracy of Gleason score and PSA as pathological predictors exists and there is the need of new parameters to better evaluate prostate cancer aggressiveness. Urotensin II (UTII) is a potent vasoconstrictor peptide and its receptor (UTII-R) is involved in prostate. In this study, we evaluated the correlation between UTII-R expression and tumor upgrading from needle biopsy to postoperative specimen and we presented a new score based on UTII-R microscopic features of neoplastic cells.
Materials and Methods
We retrospectively collected prostatic needle biopsies and radical prostate samples of 141 patients affected by prostatic adenocarcinoma Gleason ≥6, treated between 2006 to 2011 at single high volume center. For each patient, clinicopathologic data were collected. The immunohistochemical staining was performed through automated system using the kit Urotensin II Receptor Detection System. Immunostained slides were independently and blindly evaluated by two uropathologists. A new score based on UTII-R coloration intensity, intracytoplasmic location and dimension of UTII-R granules was calculated. Modelling and statistical analyses were carried out using R version 3.1.0. Multivariable logistic regression models were used to explore the independent role of UTII-R expression in predicting Gleason Score upgrading. Diagnostic validity of the model-based scores was evaluated by ROC curve analysis and measured using the Area Under the Curve (AUC).
Gleason Sum (GS) upgrading was observed in 55 patients (38.56%). The most frequent pattern of upgrading (n=20, 36.4%) was from a bGs of 3+4 to a pGS of 4+3. Although patients with GS upgrading were characterized by higher PSA values, this difference did not reach statistical significance (p=0.215). UTII-R emerged as independent predictor of upgrading. Higher score of UTII-R expression was found in 73 patients (51.7%). Neoplastic cells presented UTII-R granules bigger and located in more apical position.
Our study suggests that UTII-R expression and its microscopic features are significant related with prostate tumor upgrading and could add important information as prognostic factor in patients affected by potentially more aggressive cancer.Argomenti: