Influence of intensity of primary tumour hypoxia and vascularisation on standard prognostic factors in prostate cancer patients – are biological markers helpful in prediction of cancer disease course?

Introduction: In prostate cancer patients the standard prognostic factors include: the clinical stage, histological grade according to Gleason scale and PSA level. Reliable biological markers are being sought to supplement the scant morphological-clinical data in order to predict more precise and individualized prognosis and to select a proper therapeutic option.
Aim of the study: The aim of the study was to assess the significance of primary tumour hypoxia and vascularisation markers through deter-mining their correlation with standard prognostic factors in prostate cancer patients who underwent primary surgical treatment.
Material and methods: A retrospective analysis of 43 formalin-fixed, paraffin- embedded prostate cancers derived from patients after radical pro-statectomy was conducted. Slides with tissue specimens were immu-nohistochemically stained against the hypoxia marker Hif-1a protein and the microvascularisation marker CD34 protein. The results were statistically analyzed to assess the markers’ correlation with standard prognostic factors: pTNM stage, Gleason score and initial PSA level.
Results: A correlation was dem-onstrated between Gleason score and both biological factors studied: Hif-1a expression (R = 0.32; p < 0.05;) as well as density of vessels showing CD34 (R = 0.65; p < 0.001) expression. Further-more, a significant relationship between pTNM stage and CD34 (+) (R = 0.34; p < 0.05) vessel density was found. The intensity of primary tumour hypoxia and vascularisation may constitute an important additional prognostic indicator in prostate cancer patients. The full correlation of Gleason score with the biological markers studied suggests its leading significance among the standard prognostic factors.