Changes in adjacent benign tissue in prostate tumors may better predict the recurrence

Changes in adjacent benign tissue in prostate tumors may better predict the recurrence -

Changes in benign tissue in prostate tumors side can provide a early warning for patients at high risk of biochemical recurrence after radical prostatectomy, a study by researchers at the Case Western Reserve University and Johns Hopkins Medical Institutions shows.

biochemical recurrence, increasing antigen (PSA) prostate specific, can be used to predict cancer patients who develop prostate local recurrence, distant metastasis and death.

In a small sampling, image analysis of adjacent tissue was a better predictor than the current standard for prognosis after prostatectomy.

If preliminary results are confirmed by other studies, they can help doctors decide earlier that patients need more follow-up therapy after surgery or need to return to more regular monitoring.

"In a sense, this study is the validation of what many people think about these cancers - there is a field effect, as if the tumor is difficult to see tentacles that can affect the patient and the results, "said Anant Madabhushi, Professor F. Alex Nason II of biomedical engineering at Case Western reserve and leader of the research.

Madabhushi worked with George Lee Case Western Reserve, a research assistant professor, and Sahirzeeshan Ali, a doctoral student, and Robert W. Veltri Johns Hopkins Medical Institutions, associate professor of urology and Jonathan I. Epstein, Professor Reinhard of urologic Pathology. Their study is published in the journal European Urology focus .

The researchers analyzed the records of 70 patients who underwent radical prostatectomy from 00 to 04 with a maximum of 14 years of follow up. They scanned images of specimens of resected prostate and analyzed tumor regions and surrounding tissues that appeared to be benign.

In the group studied, 22 suffered from biochemical recurrence, metastasis or died.

The scientists used computers to search and identify the characteristics of the image that may be undetectable to the human eye but can be correlated with biochemical recurrence. They used the 10 best characteristics to develop a risk score.

They were surprised that the nuclear shape and architecture in Benin-looking tissue were more predictive of recidivism than the features found in the tumor, Madabhushi said. "Its an amazing discovery, completely unexpected."

Among the risk calculators used to assess the recurrence of prostate cancer is a variable abacus known to influence recidivism, and a Gleason score, which is based on the model of cancerous tissue compared to normal tissue.

"We managed to do better than charts and Gleason score," said Madabhushi.

But by combining the benign-road characteristics with tumor characteristics extracted from the patient's pathology images and Gleason scoring, they were able to further improve the prediction of recidivism.

All specimens and images used in this study come from Johns Hopkins. To validate the computer image analysis is universal, researchers will test images and specimens Hospital in Cleveland.

"We know information from different laboratories tend to be slightly different," said Madabhushi. "We'll see how image analysis handles these variables."

The researchers suggest that if the characteristics they identified turn out to be reliable indicators, whether used in combination with traditional tools.

"There is a clear path to a clinical test / translational" said Madabhushi. "There is no destruction of tissue -. Nothing prevents us to analyze the images and specimens and come with a risk score "