Microvessel Density Correlation with Gleason Score in Prostatic Adencarcinoma – A Computer Assisted Image Analysis in Whole-Mount Prostatecmies
Mohamed E Salama, Marta Heilbrum, Christopher Dechet, Lester J Layfield, Ting Liu. University of Utah/ARUP, Salt Lake City, UT; University of Utah, Salt Lake City, UT
Background: Angiogenesis has been well recognized as a fundamental element of a multistep process in the evolution of cancer progression, invasion, and metastasis. Previous studies on angiogenesis in prostate cancer revealed that angiogenesis plays a role in the progression of prostate cancer. Microvessel density (MVD), a measurement of prostate cancer angiogenesis, has been shown to be a predictor of metastasis and survival. Thus, targeting angiogenesis has been the subject of several clinical investigations, however pathological and morphologic studies are lacking. In this Study, we analyzed the correlation between MVD and Gleason score.
Design: The study consisted of 12 cases of prostate adenocarcinomas from patients (mean age: 61 years) who have underwgone research MRI studies with the use of an endorectal coil 3.0T. All of the specimens were entirely submitted in a whole-mount (4.5 mm section thickness) fashion, from apex to base. Slides were reviewed to determine location, size and Gleason score of carcinoma of each plane. Slides were stained with CD31 antibody (clone JC/70A, Dako, Carpinteria, CA) and were scanned using the Aperio CS Scanscope, and analyzed with Aperio's vessel algorithm (Aperio Technologies, Inc., Vista, CA, USA). MVD defined as the area occupied by number of vessels divided by the total analysis area represented in um2. Each area of Gleason score 3 and 4 was manually marked on the digitally scanned CD31 slides and value of MVD were recorded. For each stained level the MVD findings were compared according to Gleason score. T-test was used for analysis.
Results: Totally, 45 foci of Gleason pattern 3 tumor and 27 foci of Gleason pattern 4 tumor were analyzed in this study. MVD is statistically significantly higher in Gleason 4 areas (0.009662±0.00002458/um2) than that in Gleason 3 areas (0.0004841±0.000007509/um2) with a P value of 0.0091.
Conclusions: MVD in prostate cancer is closely related to Gleason grade with higher MVD noted in Gleason 4 tumor compared to Gleason 3 tumor. MVD appears to be associated with tumor aggressiveness. The benefit of angiogenesis inhibitors has become a reality in several tumor types, with significant potential in prostate cancer with higher Gleason score.
Category: Genitourinary (including renal tumors)
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 111, Wednesday Morning