Data suggest that androgen receptor AR expression in both stromal and epithelial cells of prostate cancer might be predictive of relapse following radical prostatectomy. Using a cohort of patients with prostate cancer identified at TURP for benign prostatic hypertrophy (BPH), the objective of this study was to investigate relationships between AR in both cell types and clinical parameters/outcomes.
Of men undergoing TURP for BPH between 2000 and 2007 at their institution, 66 patients had a first diagnosis of prostate cancer with Gleason grading and >5% cancer on histology. Areas of BPH and prostate cancer were identified by H&E staining, mapped onto paraffin embedded material, and duplicate 5mm cores of each used to generate a series of 6 tissue microarrays. Immunohistochemistry with AR anti-sera was scored in≥3 fields of each core by two researchers, and collapsed into sample scores of 0-9 in epithelia 0-6 in stroma for both prostate cancer and BPH. Associations between AR score and clinical parameters (Gleason, serum PSA, % cancer, prostate size, stage and cancer related death) were investigated using data dichotomized by median AR in each compartment/tissue using Wilcox Rank Sum and Barnard's Exact tests.
They reported that in epithelia, median AR levels were similar in both prostate cancer and BPH, but for stroma AR was 3.2 fold lower in prostate cancer. High epithelial AR and conversely low stromal AR were independently associated in prostate cancer samples with Gleason grade and % cancer. Serum PSA was related only to high AR content in prostate cancer epithelium. The most important finding was that prostate cancer associated death was associated exclusively with low stromal AR content (p=0.04).
Presented by Samarth Chopra, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.