ELEVATED LEVELS OF VERSICAN BUT NOT DECORIN PREDICT DISEASE PROGRESSION IN EARLY-STAGE PROSTATE-CANCER

Patients with clinically localized prostate cancer who might be cured by aggressive management are not easily identified using current clini cal information, Additional, more accurate, biomarkers of tumor behavi or need to be identified to improve clinical outcome, Our previous stu dies indicated that the concentration of the glycosaminoglycan chondro itin sulfate in prostatic stroma might be a useful biomarker of diseas e progression in early-stage prostate cancer, In this study, two chond roitin sulfate proteoglycans, versican and decorin, were investigated, Versican and decorin were immunolocalized to the periacinar and perit umoral fibromuscular stroma in sections of nonmalignant and malignant human prostate tissues, Video image measurements indicated that the co ncentrations of both proteoglycans were increased in the prostatic tis sue of men with early-stage prostate cancer compared with tissue from men without cancer (P = 0.0006), Cox's univariate analysis indicated t hat increases in versican concentration but not in that of decorin wer e associated with increased risk of prostate-specific antigen (PSA) pr ogression, Versican concentration was compared with other clinical or biological features of prognosis in two-variable regression analyses, Versican and serum PSA concentrations were independent predictors of P SA progression, Versican was a stronger prognostic factor than tumor g rade, and it could predict outcome for patients with moderately differ entiated tumors. Patients with low versican concentration had signific antly better progression-free survival than patients with high levels of versican (Kaplan-Meier plot, 89% versus 27% PSA progression-free at 5 years, respectively; P = 0.0001), We conclude that the measurement of prostatic concentrations of versican, a molecule with reported anti cellular adhesive properties, may be a useful marker of disease progre ssion in patients with early-stage prostate cancer and that further st udy of versican in other patient cohorts is warranted.