Neovascularity do not increases in prostatic cancer: impact on its predictive role
Objective: Angiogenesis is today considered a prognostic factor and therapy target in several tumours of different histological origin but remains controversial in prostate cancer (PC). Here we assess the neo-vascular surface of normal prostate and PC using a computer-aided image analysis system to evaluate its clinical utility.
Methods and results: One neoplastic and two non-tumoral prostatic biopsies sampled from 70 subjects underwent transrectal ultrasound guided biopsy, and subsequently graded as Gleason 3+3 and T1c stage were examined. A computer-aided image analysis system was used to quantify the CD34+ immunoreactive area.
Microvessel area was not significantly increased in tumour versus normal prostate. The mean vessel area was significantly higher in normal biopsies (3.25±2.29% biopsy 1; 3.43±2.04% biopsy 2), than in tumour (3.25±2,29%, P < .0002). Statistically differences between normal and tumoral vascularity surfaces were also found with regard to surgical margins, capsular invasion, biochemical relapse, clinical signs but not vascular invasion, PSA values and tumour volume. Discussion: It has been ascertained that tumour angiogenesis continues until the tumour is eradicated or the host dies, and that without blood vessels, tumours cannot grow beyond a critical size. The significance of angiogenesis in PC, however, still remains debated. Prostate histology may remain the reference method for assessing the status of neovascularity, but there are still several open questions, including whether angiogenesis is a hallmark of PC, and the absence of a powerful method of quantifying the reversal of neovascularity. ==fine abstract==