Low Numbers of Vascular Vessels Correlate to Progression in Hormone-Naïve Prostate Carcinomas Undergoing Radical Prostatectomy

Abstract

Vascularization influences tumor development by supporting the nutrition anddissemination of tumor cells. On the other hand, a low number of vascular vessels (VVlow) mayinduce hypoxia, accounting for selection of resistant clone(s) of tumor cells. This study aimed toevaluate the prognostic significance of vascular (VV) and lymphatic vessels (LV) in prostate cancer(PCa). Tumor samples from 400 PCa patients undergoing radical prostatectomy (RP) were preparedin duplex as tissue microarrays. Numbers of VV and LV were evaluated usingimmunohistochemistry detecting CD34 and podoplanin, respectively, and correlated to clinicaldata, biochemical recurrence (BR), and proteins analyzed in tumor cells. VVlow and LV were foundin 32% and 43% of patients with informative PCa samples, respectively. VVlow correlated with ashorter time to BR 3, 5, and 10 years after RP in hormone-naïve patients (p = 0.028, p = 0.027 and p =0.056, respectively). It was also shown to be an independent prognostic factor 5 years after surgery(multivariate analysis, p = 0.046). Tumors characterized by VVlow expressed the epithelial celladhesion molecule, EpCAM, less frequently (p = 0.016) and revealed a borderline correlation toincreased levels of tumor cell invasion marker Loxl-2 (p = 0.059). No correlations were found for LV.In summary, VVlow in hormone-naïve patients undergoing RP has prognostic potential and seemsto be related to an aggressive phenotype of tumor cells.