ABSTRACT
Background: Prostate cancer (PC) is the second cause of death by cancer in men in Chile. Its behavior is so variable that it is necessary to search reliable prognostic markers. Vascular Endothelial Growth Factor (VEGF) is one of the most powerful pro-angiogenic factors. There is no agreement on its validity as a diagnostic or prognostic factor. Aim: To search for VEFG in prostatic tissue. Material and Methods: This study was performed in prostatectomy tissue coming from 41 patients with PC and 39 patients with benign prostatic hyperplasia (BPH). Specimens were studied using immunohistochemical staining for VEGF. The percentage of stained glandular cells per patient was calculated and associated with pathological diagnosis in cancer patients. Results: PC biopsies had a mean of 82% of VEGF (+) stained cells, while BPH had only 1.6% (p < 0.01). No relationship was found between the percentage of staining and recurrence at one year of follow-up in the case of PC. Conclusions: These results would rule out VEGF as a prognostic factor in this series of patients.
Subject(s)
Aged , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/chemistry , Prostate/chemistry , Prostatic Hyperplasia/metabolism , Prostatic Neoplasms/chemistry , Biomarkers, Tumor/analysis , Vascular Endothelial Growth Factor A/analysis , Biopsy , Immunohistochemistry , Predictive Value of Tests , Prostate/pathology , Prostatectomy , Prostatic Hyperplasia/pathology , Prostatic Hyperplasia/surgery , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgeryABSTRACT
El cáncer de próstata (Ca P) es la segunda causa de muerte en hombres y su comportamiento es tan heterogéneo que se ha sido necesario buscar factores pronósticos que sean fiables. Entre ellos, se está investigando la angiogénesis, proceso necesario para el crecimiento y desarrollo de metástasis del cáncer. El factor de crecimiento endotelial vascular (VEGF), es uno de los factores proangiogénicos más potentes encontrados. No se ha llegado a un consenso internacional en cuanto a su validez como factor pronóstico y tampoco hay estudios en Chile que demuestren una diferencia en su presencia entre el cáncer prostático y la hiperplasia benigna prostática (HBP). Se propuso investigar ambas relaciones en nuestro medio pues contamos con la alternativa de efectuar inmunohistoquímica a pesar de nuestras clásicas limitaciones tecnológicas. Se contaron con 66 biopsias obtenidas de cirugía prostática, de las cuales 30 eran prostatectomías radicales por cáncer prostático clínicamente localizado y 36 eran HBP obtenidas por técnica transvesical. Se les realizó inmunohistoquímica para VEGF y se obtuvo el porcentaje de marcaje de células glandulares por paciente. Se encontró una relación estadísticamente significativa en el porcentaje de marcaje entre cáncer yHBP, ya que el marcaje está prácticamente ausente en la HBP. Cuando se intento correlacionar la intensidad del marcaje con la evolución y el pronóstico de los tumores no se encontró relación entre el porcentaje de marcaje y el mal pronóstico de los tumores operados como en el caso de los cánceres que evolucionaron con recidiva bioquímica definida comoPSA mayor de 0,2 ng/ml. Como expectativas de utilidad clínica podemos plantear que en el futuro el VEGF podría tener utilidad en facilitar el diagnóstico de cáncer y un eventual uso como criterio para optar por una terapia antiangiogénica.
Introduction. Prostate cancer (PCa) is the second cause of death in men and its behavior is so versatile that it has been necessary to search for reliable prognostic factors and therapeutical targets, such as angiogenesis. The Vascular Endothelial Growth Factor (VEGF) is one of the most powerful proangiogenic factors. There is no agreement on its validity as a prognostic factor. Material and methods. A case control study was performed in patients with PCa age matched with patients with benign hyperplasia (BPH). Specimens from prostatectomies were studied using immunohistochemical staining of VEGF in prostate gland cells. The percentage of stained glandular cells per patient was calculated, and associated with diagnosis and recurrence. Prostatic Specific Antigen (PSA) over 0.2 ng/ml at 1 year after the surgery was considered as a recurrence. Results. Sixty biopsies were available, obtained by radical prostatectomy, of which 30 were PCa and 30 were BPH. PCa biopsies had a proportion of VEGF stained cells of 79.5 per cent, while BPH had a 0.86 per cent of stained cells (p<0.0001). However, association between staining percentage and recurrence of the PCa was not found. Discussion: Glandular cells in prostatic cancer show a significantly different pattern of VEGF than in non neoplasic prostates. VEGF could be useful to make PCa diagnosis in cases of dubious biopsies, through positive or negative staining for VEGF. Further studies are necessary to evaluate whether VEGF pattern correlates with aggresiveness of prostate cancer.