In summary, multivariate analysis demonstrated that high serum PSA and high tissue T levels were significantly associated with poor-prognosis factors such as high Gleason score, advanced clinical stage, and high % positive cores in men with prostate cancer.
Extracapsular extension or seminal vesicle involvement, as well as high Gleason score and PSA levels, is, however, linked to high postoperative and post-radiotherapy relapse rates, with long-term control rates falling below 50% (Galalae et al, 2002; Baccala et al, 2007; Pierorazio et al, 2009).
IHC staining of a second cohort of patients (Bonn-TMA) confirmed an elevated SOCS2 expression in low- as well as high-Gleason score tumors (Supplementary Figure 1, see section on supplementary data given at the end of this article).
Similarly, a loss of stromal Cav-1 is associated with advanced disease and metastasis, as well as a high Gleason score, in prostate cancer patients [ 38].
Clinical reports indicate that Akt is significantly over-expressed in prostate tumors compared to benign prostatic tissue, and its level is directly correlated with tumor progression and prostate-specific antigen (PSA) serum levels, as well as a higher Gleason score [ 23, 26].
Briefly, the H&E-stained slides were reviewed for accuracy of Gleason scores and for the availability of adequate areas of each component Gleason grade pattern; the index tumor, defined as the largest and/or highest Gleason score, was identified on the slide; and the representative highest Gleason score areas were marked.
Prostate biopsies targeted by elastic fusion of magnetic resonance (MR) and three-dimensional (3D) transrectal ultrasound (TRUS) images may allow accurate identification of the index tumor (IT), defined as the lesion with the highest Gleason score or the largest volume or extraprostatic extension.
The Gleason score is the sum of the predominant and highest Gleason grades observed within a biopsy.
Prostate-specific membrane antigen (PSMA) is highly expressed in many prostate cancers and correlates with traditional negative prognostic factors such as a high Gleason score, metastasis or recurrent disease, but is not found in most other tissues [ 8].
Information on histological grade was available for 720 cases (75.8%); of these, 441 (46.4%) were classified as low-grade (Gleason sum <7 or equivalent, i.e. coded as moderately or as well differentiated) and 279 (29.4%) were classified as high-grade (Gleason sum ⩾7 or equivalent, i.e. coded as poorly differentiated or as undifferentiated).
