Lactate dehydrogenase is a prognostic indicator for prostate cancer patients with bone metastasis.

We analyzed clinical data to identify prognostic indicators in prostate cancer patients with bone metastasis. The subjects were 60 patients with bone metastasis out of 165 patients diagnosed with prostate cancer at our clinic over 6 years from January 1998 to December 2003. The age at the initial diagnosis was 61 to 91 (mean: 73.7 +/- 7.5) years old. The following items were considered to be possible prognostic indicators: T (type) classification, N (node) classification, Gleason score, prostate specific antigen (PSA) value before therapy, disease grade, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), serum calcium (Ca), hemoglobin (Hgb), and platelet count (Plt). The 5-year overall survival rate was 45.7% in the 60 patients. Univariate analysis showed statistically significant differences in N (1), Gleason score 7 + 8/Gleason score 9 + 10, and LDH level (p = 0.0053, 0.0261, and 0.0049, respectively). Multivariate Cox proportional hazard analysis of these three items showed a statistically significant difference in LDH level and Gleason score 9 +/- 10 (p = 0.0167 and 0.0371). LDH was suggested to be an excellent prognostic indicator, because of its objectivity and convenience of measurement, in prostate cancer patients with bone metastasis.

Prognostic significance of immunohistochemical expression of the HER-2/neu oncoprotein in bone metastatic prostate cancer.

OBJECTIVES: To investigate the usefulness of the overexpression of the human epidermal growth factor receptor (HER-2) oncoprotein in patients with bone metastatic prostate cancer as a marker for the time to recurrence and outcome after endocrine therapy. METHODS: We studied 50 patients who had been diagnosed with bone metastatic prostate cancer. HER-2 overexpression in the prostatic tissue by biopsy was evaluated by immunohistochemistry using the Hercep test. The results were scored into four levels by two pathologists; scores greater than 1+ were considered positive. RESULTS: The HER-2 staining score was 0, 1+, 2+, 3+, and indeterminate in 28, 4, 11, 6, and 1 case, respectively. HER-2 was overexpressed (greater than 1+) in 21 patients (42%). The cause-specific survival and nonrecurrence rates were significantly lower in the HER-2-positive group than in the negative group (P = 0.0084 and P = 0.0485, respectively). Furthermore, the cause-specific survival rate after recurrence was significantly greater in the HER-2-negative group than in the positive group (P = 0.0247). CONCLUSIONS: We consider that HER-2 overexpression, as measured by immunohistochemistry, may be useful as a marker of an unfavorable prognosis by predicting the interval until relapse and outcome after endocrine therapy in patients with bone metastatic prostate cancer.

Immunohistochemical study of chromogranin A in Stage D2 prostate cancer.

OBJECTIVES: To study the clinical and pathologic factors that affect the time to recurrence after hormonal therapy in patients with Stage D2 prostate cancer and to determine whether cells positive for chromogranin A (CgA) in tissue biopsied at diagnosis is a useful marker for predicting the duration to recurrence after hormonal therapy. METHODS: A total of 50 patients diagnosed with Stage D2 prostate cancer at our institution from January 1998 to December 2001 were studied. The needle prostate biopsy specimens obtained at diagnosis were stained by immunohistochemistry using the labeled streptavidin biotin method, and the results were considered positive if CgA-positive cells constituted 10% or more of the tumor area. RESULTS: No significant differences were found between patients on the basis of the time to recurrence of less than 2 years versus 2 years or more with respect to prostate-specific antigen level, patient age, Gleason score, or extent-of-disease grade. Of the 50 patients, 11 (22.0%) had positive cell staining for CgA. No significant differences were found between the CgA-positive group and the CgA-negative group in age, prostate-specific antigen level, Gleason score, extent-of-disease grade, T stage, or N stage. The rate of freedom from recurrence after 2 years as analyzed by the Kaplan-Meier method was 18.2% for the CgA-positive group and 47.4% for the CgA-negative group, and the CgA-positive group had a significantly shorter time to recurrence (P < 0.0122). CONCLUSIONS: The results of our study have shown that patients with overexpression of CgA-positive cells in the prostate have a significantly shorter time to recurrence after hormonal therapy than patients with CgA-negative cells; thus, CgA expression may be a useful marker predictive of the time to recurrence.