ASSESSMENT OF THE BIOLOGIC MARKERS P53, KI-67, AND APOPTOTIC INDEX ASPREDICTIVE INDICATORS OF PROSTATE CARCINOMA RECURRENCE AFTER SURGERY

BACKGROUND. This study was designed to evaluate the potential of the m olecular and cellular markers p53, Ki-67, and apoptotic index (AI) as adjuncts to the commonly available variables of tumor grade, clinical stage, and serum prostate specific antigen to predict prostate carcino ma recurrence after radical prostatectomy. METHODS. Representative pun ch biopsy specimens of prostate carcinoma from whole mount paraffin bl ocks were evaluated from 47 men who underwent radical prostatectomy. T wo groups were defined: those without evidence of prostate carcinoma r ecurrence after 5 years of follow-up (N = 30) and those with carcinoma recurrence (N = 17). Gleason grade, clustered p53 immunostaining, Ki- 67 immunostaining, and AI were determined by standard techniques. RESU LTS. All variables tested were associated with disease recurrence by u nivariate analysis: AI (P = 0.005), clustered p53 immunostaining (P = 0.0070), and Ki-67 immunostaining (P = 0.0390). Using multivariate ana lyses that included each biomarker with routinely available features, only AI (P = 0.0234) and clustered p53 immunostaining (P = 0.0389) add ed independent prognostic information (Ki-67 immunostaining, P = 0.128 5). In the final logistic regression model that included standard vari ables with AI and p53, only AI reached statistical significance (P = 0 .0332). CONCLUSIONS. The continued assessment of additional biomarkers for prostate carcinoma recurrence is important to identify better tho se patients who may be candidates for early adjuvant therapy and also to further our understanding of the neoplastic potential of a particul ar malignancy. (C) 1998 American Cancer Society.