TOPOGRAPHY OF NEOVASCULARITY IN HUMAN PROSTATE CARCINOMA

Background. All neoplasms require angiogenesis and resulting neovascul arity for growth. The authors and others have confirmed the staging an d prognostic significance of quantitative microvascularity density (MV D) in human prostate carcinoma (CAP). In the present investigation, th e authors sought to identify the specific site of neovascularity withi n the neoplasm and adjacent benign tissue. Methods. Histologically ben ign and malignant tissues from 14 random radical prostatectomy specime ns were studied. The tumor edge was defined precisely by immunohistoch emistry, suggesting a high molecular weight cytokeratin that stains on ly the basal cells of benign histology. Microvascularity density quant ification was performed using von Willebrand factor antigen immunohist ochemistry as previously defined. Five parallel arcs were defined alon g which vessel density was calculated including arcs within, on the ed ge, and removed from the neoplasm. Results. In 13 of 14 cases, the hig hest vessel density was found within the tumor. Significant difference s were observed between the edge of the tumor and 2.5 mm within the be nign periphery, between the benign and malignant tissue at the border, and between CAP at the edge and CAP 2.0 mm within the neoplasm. These findings suggest a stepwise increase in MVD toward the center of the neoplasm. Conclusions. These data confirm the authors' previous observ ation that prostate cancer has approximately a two-fold increase in MV D compared with the benign tissue. Moreover, high vascularization of t he center explains the rare finding of necrosis in CAP. These data sug gest that angiogenic promoters may have their highest activity in the center of the neoplasm.