Expression of prostatic acid phosphatase (PSAP) in transurethral resection specimens of the prostate is predictive of histopathologic tumor stage in subsequent radical prostatectomies

Department of Pathology, HELIOS Clinic Bad Saarow, Charité-University Medicine Teaching Hospital, Pieskower Strasse 33, 15526, Bad Saarow, Germany.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (Impact Factor: 2.65). 03/2009; 454(5):573-9. DOI: 10.1007/s00428-009-0759-1
Source: PubMed


Clinical management of incidental prostate cancer (IPC) remains challenging since its clinical course cannot be predicted by conventional histopathology. Aiming to define predictive factors in IPC, we correlated the immunohistochemically detected expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PSAP), alpha-methylacyl-CoA racemase (AMACR, p504s), and androgen receptor in transurethral resection specimens with Gleason scores and histologic staging on the corresponding radicals in a cohort of 54 patients (mean age, 65.9 years; range, 49-80 years). PSAP expression showed a significant correlation with tumor staging (rho = -0.37; p = 0.02) but not with Gleason scores (rho = -0.06; p = 0.69). K-statistics revealed a highly significant moderate interobserver agreement concerning the evaluation of PSAP staining (K = 0.47; p < 0.001). In contrast, the other markers assessed failed to correlate with conventional histopathology. Therefore, PSAP might be predictive of tumor stage in IPC and represent a valuable adjunct for clinical decisions in terms of individual therapeutic management.

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    • "After sipuleucel-T treatment of autologous cells, the product containing increased activated APCs and T cells is reinfused into the patient and contains at least 50 million autologous activated CD54+ dendritic cells, and a variable number of T cells, B cells, natural killer cells, and others [37]. Sipuleucel-T immunotherapy targets cells which express PAP, a secreted glycoprotein enzyme that is expressed in 95% of prostate tissue and PCa; expression levels correlate with tumour staging [38, 39]. Moreover, high serum PAP levels are associated with significantly shorter survival and lower responsiveness to radiation therapy [40]. "
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    • "Serum PAP levels are low in healthy individuals and increased levels are associated with PCa. For example, it is shown that PAP is aberrantly expressed in high Gleason score PCa (72, 73). Ozu et al. showed that serum PAP levels, like serum PSA, are significantly increased within the escalating PCa disease stages. "
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    • "Despite the great progress in our understanding of the disease process and standardization of diagnostic criteria for prostate cancer, the majority of prostate tumors are detected at early stages with uncertain prognosis (Larne et al., 2012). Previous studies have shown that PAP can serve as a prostate cancer marker by proportionally increasing secretory PAP expression as prostate cancer progresses (Azumi et al., 1991; Wang et al., 2005; Gunia et al., 2009). High levels of PAP expression were detected in high Gleason score prostate cancers as determined by immunohistochemistry (Gunia et al., 2009). "
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    ABSTRACT: Prostate cancer is one of the most prevalent non-skin related cancers. It is the second leading cause of cancer deaths among males in most Western countries. If prostate cancer is diagnosed in its early stages, there is a higher probability that it will be completely cured. Prostatic acid phosphatase (PAP) is a non-specific phosphomonoesterase synthesized in prostate epithelial cells and its level proportionally increases with prostate cancer progression. PAP was the biochemical diagnostic mainstay for prostate cancer until the introduction of prostate-specific antigen (PSA) which improved the detection of early-stage prostate cancer and largely displaced PAP. Recently, however, there is a renewed interest in PAP because of its usefulness in prognosticating intermediate to high-risk prostate cancers and its success in the immunotherapy of prostate cancer. Although PAP is believed to be a key regulator of prostate cell growth, its exact role in normal prostate as well as detailed molecular mechanism of PAP regulation is still unclear. Here, many different aspects of PAP in prostate cancer are revisited and its emerging roles in other environment are discussed.
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