MICROVESSEL DENSITY IN-CORE BIOPSIES OF PROSTATIC ADENOCARCINOMA - A STAGE PREDICTOR

Microvessel density was recently reported to be an independent correla te of tumour stage in whole mount prostatectomy specimens. This prompt ed an investigation of whether the quantitation of tumour microvessels could also be reliably applied to prostatic core biopsies, as a presu rgical determinant of local tumour extension. The study was performed on a series of 46 unselected patients with prostatic adenocarcinomas u ndergoing radical prostatectomy. Intratumoural microvasculature was hi ghlighted immunohistochemically using an antibody against CD31 and sub sequently evaluated at x 400 magnification in both biopsies and corres ponding prostatectomies. The highest microvessel count was reported fo r each case. Ten cases (22 per cent) had to be excluded because of ins ufficient measurable tumour areas in core biopsies. The remaining 36 c ases (16 pT2; 20 pT3) showed a high degree of correlation between micr ovessel density in biopsies and prostatectomies (P<0.0001). Similarly, pre- and post-operatively determined microvascular counts correlated well with tumour stage (P<0.0001). Furthermore, the median microvessel density in core biopsies and rumours, i.e., 34, distinguished well be tween organ-confined and organ-extending rumours (positive predictive value for pT3 tumours 94.4 per cent; sensitivity 85 per cent). These d ata indicate that the evaluation of microvessels in core biopsies, eve ntually combined with other parameters, could be a reliable method for the individual prediction of the post-surgical tumour stage of prosta tic adenocarcinoma. (C) 1997 by John Wiley & Sons, Ltd.