Cathepsin B expression in prostate cancer of native Japanese and Japanese-American patients: an immunohistochemical study.

BACKGROUND: Japanese-American (J-A) men who have immigrated to the U.S.A. and acquired the Western lifestyle usually have more invasive prostate cancer (PCa) than native Japanese (NJ) living in Japan. The specific reasons for these differences remain unknown. The objective of this study was to examine immunostainings of cathepsin B (CB) and its endogenous inhibitor stefin A (SA) in tissue microarray (TMA) and radical prostatectomy (RP) tissue sections in the hope of obtaining insights into the invasiveness of PCa in Japanese patients. PATIENTS AND METHODS: TMA and RP sections were evaluated in 50 men (25 NJ and 25 J-A) for CB and SA reaction products. The CB and SA immunostainings were imaged directly from microscope slides to a computer using a high performance charge coupled device (CCD) digital camera, quantified using Metamorph software, analyzed using the two-sample t-test, and confirmed by multiple regression analysis. RESULTS: The CB and SA proteins were localized in the carcinomatous glands and isolated cancer cells in the TMA and RP sections. The Gleason scores and pre-surgery serum total prostate-specific antigen (PSA) levels did not differ significantly in the NJ and J-A patients (p = 0.14, p = 0.16, respectively). The Chi-square analysis of clinical stage versus place of birth showed that the NJ patients had significantly more T2a and T2b clinical stages than the J-A patients who had more advanced T2c and T3a stages (p = 0.003). The CB and SA immunostainings and their ratios in Gleason score 6 tumors did not show any difference, but the CB:SA ratios in score > or = 7 tumors approached significance levels. CONCLUSION: The overall matching of specimens according to the Gleason grade/score, pre-RP serum total PSA levels, clinical stage and age prior to evaluation of immunostainings greatly minimizes subjectivity associated with the evaluation of markers in this ethnic sub-population of PCa patients. CB and SA immunostaining is similar in Japanese patients who have organ-confined and moderately-differentiated PCa. Analysis of the reaction product data provides indirect evidence that invasiveness of PCa is similar in the two Japanese patient populations.

Cathepsin B expression is similar in African-American and Caucasian prostate cancer patients.

BACKGROUND: Increased incidence and mortality of prostate cancer (PCa) suggest that U.S. African-American men have more invasive cancer than Caucasian men. Invasive PCa requires several proteases, including the cysteine protease cathepsin B (CB), for degradation of basement membrane and extracellular matrix proteins prior to cancer cell migration across biological compartments. Our objective was to determine whether CB immunostaining patterns, in relation to clinical data, could distinguish invasive PCa in African-American and Caucasian patients. PATIENTS AND METHODS: Fifty Gleason score 6/7 PCa cases were selected for similar clinical data with benign prostatic hyperplasia (BPH) samples as controls. Immunostainings were imaged directly from microscope slides to a computer using a digital camera. Data were quantified using Metamorph software, analyzed using the two-sample t-test and confirmed by multiple regression. RESULTS: Ratios of CB to its endogenous inhibitor stefin A (SA) immunostainings were greater in PCa than BPH, but were not significantly different in PCa of either race. The African-American patients did not show increased CB immunostaining, indicating that the contribution of this protease to invasiveness was similar in both races. CONCLUSION: When veterans received equal medical care at the Minneapolis Veterans Affairs Medical Center, African-American patients did not show increased PCa invasiveness. Our conclusion is supported by analysis of post-surgery serum total PSA levels and cancer cell invasion to margins/capsules, seminal vesicles and/or lymph nodes. Invasiveness of PCa does not appear to be race-dependent. The previous conclusion of race-based differences in PCa requires re-evaluation with respect to the role of proteases (such as CB, matrix metalloproteinase) in invasion and metastasis of cancer cells.

Heterogeneity of cathepsin B and stefin A expression in Gleason pattern 3+3 (score 6) prostate cancer needle biopsies.

BACKGROUND: There is a significant positive association of increased ratios of cathepsin B to its endogenous inhibitor stefin (cystatin) A in prostatectomy tumors with pelvic lymph node metastases. Needle biopsy diagnosis of prostate cancer is critical in initial treatment selection. The objective was to characterize cathepsin B and stefin A immunostaining patterns in needle biopsies of histologically similar Gleason pattern 3+3 (score 6) foci in relation to pretreatment clinical data. MATERIALS AND METHODS: Immunostaining of cathepsin B and stefin A of 65 biopsy sections were imaged, quantified and analyzed with Student's t-test (p < 0.05). RESULTS: Patients had T1c to T3b clinical stages and pre-surgery total prostate-specific antigen serum levels from 1.25 to 20.0 ng/ml. Cathepsin B and stefin A reaction products were found in the cytoplasm of basal and columnar/cuboidal cells of benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and neoplastic cells. Ratios of cathepsin B to stefin A were significantly higher in prostate cancer when compared to that in BPH and PIN glands. CONCLUSION: Small foci of Gleason pattern 3+3 tumors in needle biopsies have heterogeneous cathepsin B and stefin A immunostaining. Stratification of these tumors in relation to clinical stage by cathepsin B and stefin A may assist in treatment selection.