Determining Risk of Biochemical Recurrence in Prostate Cancer by Immunohistochemical Detection of PTEN Expression and Akt Activation

• Published in: Clinical cancer research Vol. 13; no. 13; pp. 3860 - 3867
• Main Authors: BEDOLLA, Roble, PRIHODA, Thomas J, KREISBERG, Jeffrey I, MALIK, Shazli N, KRISHNEGOWDA, Naveen K, TROYER, Dean A, GHOSH, Paramita M
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.07.2007
• Subjects: Adult; Aged; Aged, 80 and over; Akt; Antineoplastic agents; biochemical recurrence; Biological and medical sciences; biomarker; Cell Survival; Enzyme Activation; Gene Expression Regulation, Neoplastic; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Odds Ratio; Pharmacology. Drug treatments; prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - metabolism; Proto-Oncogene Proteins c-akt - biosynthesis; PSA; PTEN; PTEN Phosphohydrolase - biosynthesis; Recurrence; Risk; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Immunohistochemistry; Relapse; Urinary system disease; Prostate disease; Akt protein kinase; Biochemistry; Malignant tumor; Gene expression; Epidemiology; Anatomic pathology; Risk factor; PTEN Gene; Diagnosis; Detection; Male genital diseases; Prostate cancer; Tumor suppressor gene
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-07-0091

Purpose: A considerable fraction of patients who undergo radical prostatectomy as treatment for primary prostate cancer experience biochemical recurrence detected by elevated serum levels of prostate-specific antigen. In this study, we investigate whether loss of expression of the tumor suppressor phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and the phosphorylated form of the cell survival protein Akt (pAkt) predicts biochemical recurrence. Experimental Design: Expression of PTEN and pAkt was detected by immunohistochemistry in paraffin-embedded prostate cancer tissue obtained from men undergoing radical prostatectomy. Outcome was determined by 60-month follow-up determining serum prostate-specific antigen levels. Results: By itself, PTEN was not a good predictor of biochemical recurrence; however, in combination with pAkt, it was a better predictor of the risk of biochemical recurrence compared with pAkt alone. Ninety percent of all cases with high pAkt and negative PTEN were recurrent whereas 88.2% of those with low pAkt and positive PTEN were nonrecurrent. In addition, high Gleason scores resulted in reduced protection from decreased pAkt and increased PTEN. By univariate logistic regression, pAkt alone gives an area under the receiver-operator characteristic curve of 0.82 whereas the area under the receiver-operator characteristic curve for the combination of PTEN, pAkt, and Gleason based on a stepwise selection model is 0.89, indicating excellent discrimination. Conclusions: Our results indicate that loss of PTEN expression, together with increased Akt phosphorylation and Gleason score, is of significant predictive value for determining, at the time of prostatectomy, the risk of biochemical recurrence.