Prognostic significance of the assessment of the expression of immunohistochemical markers and the degree of pathomorphism before and after treatment of patients with prostate cancer at high risk of progression

Purpose: to analyze the expression of immunohistochemical markers in patients with prostate adenocarcinoma at high risk of progression before and after combined and combined treatment of patients with prostate specific antigen (PSA) level of blood below discriminatory. Material and methods. Examined patients (n = 80) with a diagnosis of “High-risk progression prostate cancer,” with clinical stage T3a, total score for Gleason scale from 8 to 10, the level of total PSA more than 20 ng / ml. Patients of the 1st group (n = 42) only combined surgical treatment in the scope of TUR and HIFU ablation the prostate; The 2nd group of patients (n = 38) additionally applied androgen deprivation in adjuvant mode. Results. Blood PSA, determined in patients after various methods of treatment is not always an objective indicator of its effectiveness. Immunohistochemical studies of tumor tissue for proliferative activity tumor cells, the activation of apoptosis in them, as well as the assessment of specific tumor markers and tumor suppressor genes showed that a decrease in the expression of these markers in patients with PSA values of blood lower than discriminatory observed in all patients independently on the type of treatment. However, after treatment in the 1st group of patients, despite the achievement PSA level of nadir, there is a decrease in the expression of an intercellular adhesion marker E-cadherin, which indicates an increased risk of tumor metastasis, as well as increased expression of markers of the apoptosis inhibitor Bcl-2 and androgens, which indicates about the possibility of progression of tumor growth. Conclusion For a more accurate assessment therapeutic pathomorphism in patients with prostate cancer at high risk of progression, which HIFU ablation monotherapy was carried out, along with the determination of blood PSA level, it is necessary during the control biopsy of the prostate immunohistochemical studies of tumor tissue to determine the prognosis and risk of relapse.