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DNA ploidy, serum prostate specific antigen, histological grade and immunohistochemistry as predictive parameters of lymph node metastases in T1‐T3/M0 prostatic adenocarcinoma
Author(s) -
Berner A.,
Waere H.,
Nesland J.M.,
Paus E.,
Danielsen H.E.,
Fosså S.D.
Publication year - 1995
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1995.tb07227.x
Subject(s) - medicine , prostate , lymph node , immunohistochemistry , prostatic acid phosphatase , pathology , prostate specific antigen , carcinoma , metastasis , adenocarcinoma , univariate analysis , cancer , multivariate analysis
Objective To evaluate whether DNA ploidy and immunohistochemistry performed in primary prostatic carcinoma specimens give predictive information on regional lymph node metastasis in addition to T category, histological grade and serum prostate specific antigen (PSA). Patients and methods Pre‐treatment TURP specimens from 80 patients with prostatic carcinoma T0‐T3/M0 disease were retrospectively evaluated by means of DNA ploidy and histological grade, and immuno‐staining for PSA, prostatic acid phosphatase (PAP), neuron‐specific enolase (NSE) and p53 protein. Pelvic lymph node dissection was performed in all patients. Serum PSA was determined in 76 of the 80 patients before pelvic staging lymphadenectomy. Thirty‐two (40%) of the 80 patients had pN+ disease. Results Thirty‐six patients (46%) had serum PSA values below the upper reference limit (≤ 10 μg/L). By univariate analysis the pN category correlated with the serum PSA level ( P <0.001), histological grade ( P <0.001), tissue PSA ( P <0.001), tissue PAP ( P <0.04), T category ( P <0.005) and DNA ploidy ( P <0.02). Multivariate analysis revealed that the serum PSA level was the most powerful independent prognosticator, followed by the T category, tissue PAP and tissue PSA. Histological grade and DNA ploidy did not reach the level of significance in the multivariate analysis. Conclusion These data suggest that tissue PAP and tissue PSA predict the pN status in patients with T0‐T3/M0 prostate carcinoma, in addition to serum PSA and T category. Neuroendocrine differentiation and p53 protein seem to have no predictive ability.