Ma. Rubin et al., Microvessel density in prostate cancer: Lack of correlation with tumor grade, pathologic stage, and clinical outcome, UROLOGY, 53(3), 1999, pp. 542-547
Objectives. Angiogenesis is believed to play an important role in tumor pro
gression and metastasis. Previous studies have suggested that the microvess
el density (MVD) of prostate tumors may be of prognostic value. This study
investigated the reliability of assessing MVD in radical prostatectomy spec
imens and its value as an independent prognostic indicator in men with clin
ically localized prostate cancer.
Methods, One hundred radical prostatectomy specimens from 1993 to 1995 were
randomly selected for this study. Thirteen cases were excluded because the
patients had undergone neoadjuvant hormonal therapy or tissue blocks were
unavailable. The median follow-up time was 36 months. Tumor blocks were imm
unostained using the endothelial-specific antibody CD31. MVD was counted in
areas with the greatest microvessel immunostaining, which were designated
"hot spots." MVD was analyzed for associations with clinical and pathologic
factors. In a subset of 60 cases, the same observer repeated the counts th
ree times.
Results. Intraobserver reliability for MVD counting was excellent (reliabil
ity coefficient: 0.82), demonstrating that this method could be reproduced
by a single observer. MVD was not associated with Gleason sum, tumor stage,
surgical margin status, or seminal vesicle invasion. Of the 87 patients, 2
0 (23%) had a prostate-specific antigen (PSA) failure during a 36-month med
ian follow-up time. As expected, Gleason sum and tumor stage were strong pr
edictors of PSA failure, with risk ratios of 2.1 and 2.3, respectively. In
contrast, MVD was not associated with PSA failure.
Conclusions. MVD, as determined by CD31, can be reliably measured by a sing
le observer, but it is not a useful prognostic indicator for men with clini
cally localized prostate cancer. (C) 1999, Elsevier Science Inc. AII rights
reserved.