CRP Expression in Prostatic Adenocarcinoma.
Sarfraz Ali, Elizabeth Chastain, Qiqin Yin-Goen, Andrew N Young, Adeboye O Osunkoya. Emory University School of Medicine, Atlanta
Background: Prostatic adenocarcinoma is the most common non-cutaneous malignancy in men here in the United States, and is one of the leading causes of cancer related deaths in men. C-reactive protein (CRP) is an acute phase reactant that is stimulated by interleukin-6. It has recently been demonstrated that elevated plasma CRP levels appears to be one of the strong predictors of biochemical failure and poor outcome in patients undergoing androgen deprivation therapy for prostatic adenocarcinoma. However, the correlation between intratumoral CRP expression and Gleason score of prostatic adenocarcinoma has not been studied.
Design: A search of the surgical pathology files at our academic institution was performed for radical prostatectomy, transurethral resection of prostate, and prostate needle core biopsy specimens signed out as prostatic adenocarcinoma. A representative unstained section of the tumor in each of the selected cases was obtained. TMA was not utilized to avoid the possibility of variability of marker expression between tissue cores. Immunohistochemical stains for CRP were performed. Staining intensity was graded as follows: negative, 0; weak, 1+; moderate, 2+; and strong, 3+. The staining intensity was then correlated with the Gleason score for each selected case.
Results: A total of 100 cases were selected. Cases were stratified based on Gleason score. 25 cases each of prostatic adenocarcinoma, Gleason scores 3+3=6, 3+4=7, 4+4=8 and 4+5=9 were analyzed. Mean patient age was 64 years (range 36-92 years). There was increased intratumoral expression of CRP in cases of prostatic adenocarcinoma, Gleason score 3+4=7 compared to cases of prostatic adenocarcinoma, Gleason score 3+3=6. However, there was more statistically significant increase in the intratumoral expression of CRP in cases of prostatic adenocarcinoma, Gleason score 4+5=9 (p=0.001), compared to all the other Gleason scores in this cohort, including cases of prostatic adenocarcinoma, Gleason score 4+4=8.
Conclusions: To our knowledge, this is the first study to date on the analysis of intratumoral expression of CRP in prostatic adenocarcinoma. There is a statistically significant increase in intratumoral CRP expression in cases of prostatic adenocarcinoma, Gleason score 4+5=9 compared to cases with lower Gleason scores. It is highly conceivable that increased intratumoral expression of CRP occurs as prostate cancer dedifferentiates. Intratumoral CRP may also play a critical role in the pathobiology of androgen-independent prostatic adenocarcinoma, thus leading to biochemical failure in patients who are undergoing androgen deprivation therapy for prostatic adenocarcinoma.
Category: Genitourinary (including renal tumors)
Wednesday, March 2, 2011 9:30 AM
Poster Session V # 64, Wednesday Morning