96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Abstracts
SA-P-081
Significance of Gleason Grading in a clinical setting that considers
active surveillance as a therapeutic option of prostatic low grade
cancer
B . Helpap 1 , G . Kristiansen 2 , J . Köllermann 3 , U . Oehler 1 , C . Fellbaum 1
1 HBH-Hospital, Dept . Pathology, Singen, 2 University of Bonn, Dept . Pathology,
Bonn, 3 HKS-Wiesbaden, Dept . Pathology, Wiesbaden
Aims. Active surveillance has become an increasingly accepted clinical
strategy to handle patients with presumably insignificant carcinomas
by observant waiting, without endangering the curative intent. Aim of
this analysis was to evaluate the diagnostic value of nuclear features in
addition to Gleason grade in the prediction of non-aggressive disease in
a large and representative prostate cancer cohort.
Methods. A cohort of 968 prostatectomy specimens with matching preceding
biopsies (12 cores) was morphologically analysed. Architectural
features according to Gleason and cytological grading were recorded
and compared.
Results. The combination of architectural and cytoplogical features as
incorporated in the Helpap Grading increase the rate of agreement of
grading between the biopsy and the prostatectomy specimens especially
GS 6 up to 90%. The parallel use of Gleason and Helpap grading allows
for a better prediction of organ confined disease (pT2) following prostatectomy.
Conclusions. By adding cytologic features to Gleason grading, an increased
diagnostic accuracy in the identification of low grade carcinomas,
which may be treated by active surveillance, can be achieved.
SA-P-082
The Microtubule-associated Protein 2 (MAP2) is frequently expressed
in prostate cancer and its precursor lesions
M . Majores1 , E . Krappe1 , N . Wernert1 , J . Ellinger2 , G . Kristiansen1 1 2 University of Bonn, Department of Pathology, Bonn, University of Bonn,
Department of Urology, Bonn
Aims. The microtubule-associated protein 2 (MAP2) is involved in microtubule
assembly and plays a crucial role for nucleation and stabilization
of microtubules. MAP2 is frequently expressed in mature neurons
and tissue with neuroendocrine differentiation.
Methods. We incidentally revealed that MAP2 is expressed in prostate
cancer (PCA) and have evaluated the immunohistochemical characteristics
of MAP2 expression in 107 PCA specimens in comparison to adjacent
normal and dysplastic tissue.
Results. MAP2 expression was strikingly focused on high-grade PIN lesions
and invasive tumour glands: moderate or strong immunolabelling
was found in 92% of high-grade PIN (n=61/68) and in 58% (n=62/107) of
low-grade PIN lesions. In contrast, normal glands or hyperplastic epithelia
of the periurethral zone stained weakly. Invasive carcinoma was
MAP2-positive in 86% of Gleason pattern (GP) 3 glands (n=89/103), in
78% of GP 4 (n=28/36) and in 75% of GP 5 areas (n=6/8). In several cases,
MAP2 was expressed in high-grade PINs with continuous transition to
invasive carcinomas.
Conclusions. Our preliminary findings support MAP2 as a promising
new immunomarker for PCA and PIN lesions and moreover point to
MAP2 as an “interface marker” in the progression from in-situ lesions to
invasive carcinomas. We currently conduct correlations between MAP2
expression and clinicopathological features including patient survival
times.
164 | Der Pathologe · Supplement 1 · 2012
SA-P-083
CyclinD1 expression indicates possible lymph node metastasis in
invasive bladder cancer
J . Rokahr1 , E . Herrmann2 , M . Bögemann2 , S . Bierer2 , E . Eltze3 1 2 University of Muenster, Institute of Pathology, University of Muenster,
Department of Urology, 3Institute of Pathology Saarbrücken Rastpfuhl,
Saarbrücken
Aims. Overexpression of proteins involved in antiapoptosis or proliferation
is often associated with tumour progression and treatment resistance.
Cyclin D1 and BCL2 play a potential role in progression of bladder cancer
like Ki67 and TP53.
Methods. Immunhistochemical stainings were performed for Cyclin D1,
BCL2, TP53 and Ki67 on TMA containing paraffin embedded tissues of
219 invasive bladder cancer patients who had undergone radical cystectomy
between 1987 and 2004. The results were correlated with clinicopathological
parameters and overall and recurrence-free survival.
Results. Expression of the BCL2 was found in only 19 tumours, and only
moderately in 6 of these. Overexpression of BCL2 correlated with a low
proliferation rate (Ki67< 10%, p=0.067) and a low grade (p=0.004). No
correlation could be found to pTstage or TP53 expression or survival
data. Cyclin D1 expression of correlated significantly with pN1 (p=0.031),
whereas no correlations to tumour stage, grade, TP53 expression or proliferation
rate could be detected. Kaplan Meier analysis showed a significant
shorter overall survival for patients with Cyclin D1 expression
tumours (p=0.022).
Conclusions. The correlation between Cyclin D1 expression and lymph
node metastasis and a poor prognosis in invasive bladder cancer after
cystectomy indicates a role in mediating invasion and metastasis of cancer
cells.
SA-P-084
High IMP3 protein expression is a negative prognostic factor in
advanced urothelial carcinoma of the bladder
H . Reis1 , 2 , F . vom Dorp3 , C . Niedworok3 , C . Niedworok4 , A . Melchior-Becker4 ,
J .W . Fischer4 , D . Gödde1 , B .B . Singer5 , A . Bankfalvi2 , I . Romics6 , K .W . Schmid2 ,
S . Störkel1 , S . Ergün5 , H . Rübben3 , T . Szarvas3 , 7
1 2 University of Witten/Herdecke, Institute of Pathology, Wuppertal, University
of Duisburg-Essen, Institute of Pathology and Neuropathology, Essen,
3 4 University of Duisburg-Essen, Department of Urology, Essen, University
of Duisburg-Essen, Institute of Pharmacology and Clinical Pharmacology,
Essen, 5University of Duisburg-Essen, Institute of Anatomy, Essen, 6Semmel weis University Budapest, Department of Urology, Budapest, Hungary,
7Medical University of Vienna, Department of Urology, Wien, Austria
Aims. The identification of the prognostic influence and interactions of
the Insulin-like growth factor mRNA-binding protein 3 (IMP3) in advanced
urothelial carcinoma of the bladder (UCB).
Methods. A total of 224 urothelial bladder carcinoma cases were studied
regarding IMP3 expression by immunohistochemistry, real-time PCR
and Western blot analyses. The molecular targets of IMP3 – CD44, IGF2
and its receptor IGF1-R – were also investigated. Expression levels were
correlated with clinical follow-up data in univariate and multivariate
analyses.
Results. In high-stage and high-grade UCB both IMP3 protein and
mRNA levels were significantly elevated. In muscle-invasive cancer
IMP3 protein but not gene expression proved to be an independent
predictor of disease-specific (HR=2.58, 95%CI 1.28–4.56, p=0.004) and
overall survival (HR=2.07, 95%CI 1.12–3.82, p=0.020). IGF2 and CD44
expression showed no correlation with that of IMP3.
Conclusions. Identification of high IMP3 protein levels in UCB might aid
in the selection of patients at high risk for disease progression and in the
stratification to groups with more intensive therapy or strict follow-up.
No tumor promoting effect of IMP3 in its regulatory action on IGF2 and
CD44 expression was observable.