THE PROGNOSTIC VALUE OF PRETREATMENT EXPRESSION OF ANDROGEN RECEPTOR AND BCL-2 IN HORMONALLY TREATED PROSTATE-CANCER PATIENTS

Purpose: We determined the prognostic value of oncoprotein bcl-2 and a ndrogen receptor expression in pretreatment transurethral resection sp ecimens of hormonally treated prostate cancer patients, Materials and Methods: A total of 68 pretreatment transurethral resection specimens, 30 radical prostatectomy specimens and 21 palliative transurethral re section specimens with androgen independent prostate cancer was staine d with a monoclonal antibody against bcl-2. Androgen receptor immunohi stochemistry was performed on pretreatment transurethral resection spe cimens only. Results were scored semiquantitatively and were correlate d with tumor stage and grade and with the occurrence of clinical progr ession or tumor related death. Results: Bcl-2 expression by adenocarci noma cells was found in 32, 17 and 24% of pretreatment transurethral r esection, radical prostatectomy and palliative transurethral resection specimens, respectively. The bcl-2 scores did not correlate with tumo r stage or grade, Androgen receptor was expressed in 88% of pretreatme nt transurethral resection specimens. Androgen receptor scores were ma rginally related to tumor grade, but not to tumor stage, A prognostic value of bcl-2 or androgen receptor in pretreatment transurethral rese ction specimens was not found. When a combined bcl-2/androgen receptor score was used, this parameter was an independent prognostic marker t o predict clinical progression with Gleason grade and stage classifica tion. Gleason grade was the only independent prognostic marker to pred ict tumor related death. Conclusions: The expression of bcl-2 and andr ogen receptor in pretreatment prostate cancer specimens is not related to the prognosis of hormonally treated prostate cancer. Bcl-2 express ion is not increased in endocrine therapy resistant prostate cancer. S urprisingly, a combined bcl-2/androgen receptor score acts as an indep endent prognosticator for clinical progression.