Wednesday, May 06, 2009

Molecular Markers Linked to Death From Prostate Cancer

Cancer patients with bcl-2, p53, high microvessel density had higher risk of cancer death

06 may 2009 -- Several molecular factors measured in prostate cancer biopsy specimens at diagnosis may point to a higher long-term risk of death, according to research published in the May 5 Annals of Internal Medicine.

John Concato, M.D., of the Veterans Affairs Connecticut Healthcare System in West Haven, and colleagues analyzed data from 1,172 men diagnosed with prostate cancer between 1991 and 1995, whose median age at diagnosis was 72. Tissue samples from most of the men were evaluated for factors including bcl-2 (related to apoptosis), p53 (tumor-suppressor oncogene), and microvessel density.

The researchers discovered that during follow-up, 21.5 percent of deaths were attributable to prostate cancer. Bcl-2 and p53 were associated with death from prostate cancer (adjusted hazard ratio for positive versus negative staining, 1.61 and 1.48, respectively), as was microvessel density (adjusted hazard ratio for highest versus lowest quartile, 3.20).

"Although Concato and colleagues show that p53 and bel-2 detection and microvessel density are statistically associated with a worse prognosis, the authors themselves describe the advance made by their study as 'incremental.' We agree. We doubt that their findings will have any effect at all on clinical practice for several reasons," write the authors of an accompanying editorial, pointing out that "the hazard ratios are of insufficient magnitude for the markers by themselves to influence clinical decisions."

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