Abstract
In this retrospective pilot study, the expression of the prostate-specific membrane antigen (PSMA), the epithelial cell adhesion molecule (EpCAM), the vascular endothelial growth factor (VEGF) and the gastrin-releasing peptide receptor (GRPR) in locally recurrent prostate cancer after brachytherapy or external beam radiotherapy (EBRT) was investigated, and their adequacy for targeted imaging was analyzed. Prostate cancer specimens were collected of 17 patients who underwent salvage prostatectomy because of locally recurrent prostate cancer after brachytherapy or EBRT. Immunohistochemistry was performed. A pathologist scored the immunoreactivity in prostate cancer and stroma. Staining for PSMA was seen in 100% (17/17), EpCAM in 82.3% (14/17), VEGF in 82.3% (14/17) and GRPR in 100% (17/17) of prostate cancer specimens. Staining for PSMA, EpCAM and VEGF was seen in 0% (0/17) and for GRPR in 100% (17/17) of the specimens’ stromal compartments. In 11.8% (2/17) of cases, the GRPR staining intensity of prostate cancer was higher than stroma, while in 88.2% (15/17), the staining was equal. Based on the absence of stromal staining, PSMA, EpCAM and VEGF show high tumor distinctiveness. Therefore, PSMA, EpCAM and VEGF can be used as targets for the bioimaging of recurrent prostate cancer after EBRT to exclude metastatic disease and/or to plan local salvage therapy.
Highlights
Prostate cancer is the most commonly diagnosed cancer among men, and its incidence rates remain as the highest in many regions of the world [1]
Staining for prostate-specific membrane antigen (PSMA), epithelial cell adhesion molecule (EpCAM) and vascular endothelial growth factor (VEGF) was seen in 0% (0/17) and for gastrin-releasing peptide receptor (GRPR) in 100% (17/17) of the specimens’ stromal compartments
This study has shown that PSMA, EpCAM, VEGF and GRPR are expressed in locally recurrent prostate cancer after brachytherapy and external beam radiotherapy
Summary
Prostate cancer is the most commonly diagnosed cancer among men, and its incidence rates remain as the highest in many regions of the world [1]. Significant expression of certain antigens in prostate cancer as compared to normal tissue could be used for antigen-targeted imaging or therapy. Ross et al demonstrated a significant correlation between PSMA expression in prostate cancer and the Gleason score, pathological stage and biochemical recurrence [11]. The role of ProstaScint in the diagnosis of recurrent disease has to be elucidated [24] Another antigen that can be used as an imaging target is the epithelial cell adhesion molecule (EpCAM). There is no knowledge about the expression of PSMA, EpCAM, VEGF and GRPR in locally recurrent prostate cancer after brachytherapy or external beam radiotherapy. The aim of this pilot study was to investigate the expression of these antigens using immunohistochemistry and to analyze their potency for new diagnostic applications in locally recurrent prostate cancer
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