Progressive activity in latent prostate carcinoma defined by argyrophilic staining of the nucleolar organizer regions (AgNOR)

Significance of chemoprevention for prostate cancer development: experimental in vivo approaches to chemoprevention

Prostate cancer is the most common tumor in men in Western countries and mortality in Asian countries from the disease appears to be constantly increasing. Characteristics include (i) frequent discovery of latent carcinoma, even in countries with low incidences of clinical cancer; (ii) very long time to clinically significant cancer; (iii) few patients under 50 years of age (primarily a disease of elderly men); (iv) strong influences of environmental factors such as food; (v) temporal effectiveness of androgen deprival therapy; and (vi) no effective therapeutic approaches once hormone-refractory neoplasms have developed. Therefore prostate cancer is particularly indicated for preventive efforts, especially chemoprevention. Several large-scale chemoprevention trials have in fact been conducted and some have found suppressive effects. However, not all have been proven to have benefit. Experimental preclinical investigations, particularly using animal models, are recommended to find better chemopreventive agents with less adverse effects. Data using rat models have generated very interesting findings from which mechanism-based strategies can be proposed. In the present report the importance of chemoprevention of prostate cancer will be discussed using the data on human and rat prostate cancer development.

Differences between latent and clinical prostate carcinomas: lower cell proliferation activity in latent cases

BACKGROUND

Biological significance of prostate latent cancers as early phase of clinical cancers has been controversial. The characterization of the latent cancer may be important to investigate differences between latent and clinical prostate cancers.

METHODS

Latent cancers of the prostate, discovered at autopsy in men with no prior treatment for prostate disease and clinical prostate cancers, were compared for cell proliferation activities with parameters such as markers Ag-nucleolar organizer regions (AgNOR), topoisomerase II-alpha, and Ki-67. We also immunohistochemically studied alpha-methylacyl-CoA racemase (AMACR) expression that was recently identified as a possible positive marker of the prostate cancers. We analyzed 50 latent cancers and 50 clinical cancers, and samples were analyzed with Gleason grades or tumor volume.

RESULTS

In the latent cancers, Gleason grades 1-4 were observed, but in the clinical cancers Gleason grades 2-5 were recognized. Cell proliferation activities were significantly lower in the latent cancers in Gleason grade 3, and similar results were obtained but without statistical significance in Gleason grades 2 and 4. When analysis was performed according to the tumor size, it was shown that the growth activities of the tumor of the clinical cancer were higher than the latent cancer.

CONCLUSIONS

These results indicate that proliferation activities of the latent cancers were lower than the clinical cancers at the same Gleason grades. The data also suggest that latent cancers are just of preclinical stage and there is a possibility to progress to clinical ones by changing life style and longer life expectancy.

Cell proliferation indexes: a biomarker in solid tumors

Clinical studies have shown that carcinogenesis is linked to the development of proliferative abnormalities. Proliferative activity has been found to have prognostic significance in a variety of human tumors. Because proliferative abnormalities can precede the occurrence of morphological abnormalities, their measurement could also serve as useful biomarkers for chemoprevention trials. The variety of techniques for measuring cell proliferation in routine sections include mitosis counting, AgNORs, DNA precursor uptake (bromodeoxyuridine), and immunohistochemical detection of cell cycle proteins (PCNA, Ki-67/MIB-1). It is essential that the virtues and limitations of these methods be examined to ensure collection of meaningful clinical data.