Back to Search Start Over

Endothelin-1: a predictor of extracapsular extension in clinically localized prostate cancer?

Authors :
Menard J
Durlach A
Barbe C
Joseph K
Lorenzato M
Azemar MD
Perez T
Birembault P
Staerman F
Source :
BJU international [BJU Int] 2011 Jul; Vol. 108 (2 Pt 2), pp. E104-9. Date of Electronic Publication: 2010 Nov 23.
Publication Year :
2011

Abstract

Objective: To assess the value of endothelin-1 (ET-1) expression in predicting extracapsular extension (ECE) in clinically localized prostate cancer (PCa).<br />Patients and Methods: ET-1 expression was determined by immunohistochemistry on archival needle biopsies (NBs) from 94 patients (49 pT2 and 45 pT3a) who underwent radical prostatectomy (RP) for clinical T1-T2 PCa. Each sample was analysed independently by two pathologists blinded to the clinical data.<br />Results: In univariate analysis, high ET-1 expression in NBs, pre-operative prostate-specific antigen (PSA) level >10 ng/ml, percentage of positive biopsy cores and NB Gleason score ≥7 were significantly associated with ECE as determined on subsequent RP. No significant association was found between clinical stage and ECE. In multivariate analysis, there was a significant association with high ET-1 expression in NBs (p = 0.006), pre-operative PSA level >10 ng/ml (p = 0.049), and NB Gleason score ≥7 (p = 0.002). These three pre-operative factors combined provided the best model for predicting ECE with 93.3% sensitivity, 49% specificity, 62.5% positive predictive value, 88.9% negative predictive value. The combination yielded a higher concordance index (0.760 vs 0.720) and offered a higher log partial likelihood than the same model without ET1 (112.8 vs 105.7, p = 0.01).<br />Conclusions: ET-1 expression was strongly associated with ECE and, when combined with pre-operative PSA level and Gleason score, improved the predictive accuracy of pre-operative NBs. Its assessment in patients with localized PCa might be useful when making treatment decisions. Further studies with standardisation of immunohistochemical staining and multi-institutional validation are now needed to establish the appropriate use of ET-1 staining in PCa staging and to evaluate inter-observer reproducibility.<br /> (© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.)

Details

Language :
English
ISSN :
1464-410X
Volume :
108
Issue :
2 Pt 2
Database :
MEDLINE
Journal :
BJU international
Publication Type :
Academic Journal
Accession number :
21091977
Full Text :
https://doi.org/10.1111/j.1464-410X.2010.09879.x