Cavalcante Sara Lourrane Carneiro De Andrade, Barros Silva Paulo Goberlânio De, Hirth Carlos Gustavo, Frederico Ingrid Kellen Sousa, Furtado Cristiana Libardi Miranda, Ó Pessoa Cláudia Do, Barreto Giulianna Aparecida Vieira, Gonzaga Silva Lúcio Flávio
Postgraduate Program in Oncology, Haroldo Juaçaba Hospital, Ceará Cancer Institute (ICC), Brazil.
Department of Pharmacology, Postgraduate Program in Pharmacology, Federal University of Ceará, Brazil.
Asian Pac J Cancer Prev. 2025 Jan 1;26(1):77-83. doi: 10.31557/APJCP.2025.26.1.77.
This study aimed to investigate the influence of p16 immunohistochemical expression on the biochemical recurrence rate of pT2-pT3 prostate cancer.
A total of 488 pT2-pT3 stage prostate adenocarcinomas undergoing radical prostatectomy were included in this study. Following a review of Gleason classification and retrieval of sociodemographic and clinicopathological data, as well as the date of last consultation and biochemical recurrence, immunohistochemistry for p16 was performed. Data were associated using the chi-square test, Fisher's exact test, and multinomial logistic regression model.
A total of 432(94.5%) cases showed positivity for p16 with an average of 37.38±27.32% positive cells and a mean histoscore of 2.70±2.24. A total of 117 (18.4%) patients experienced biochemical recurrence within three years, which was directly associated with high preoperative PSA (p=0.007), positive surgical margins (p<0.001), pT3 staging (p<0.001), nodal involvement (p<0.001), Gleason score > 3+4 (p<0.001), <50% positivity for p16 (p=0.035), and histoscore p16 =<3 (p=0.004). In multivariate analysis, Gleason score > 3+4 (HR = 3.08 (95% CI = 1.69-5.62), positive surgical margins (HR = 2.93 (95% CI = 1.70-5.04), and histoscore p16 =<3 (HR = 2.49 (95% CI = 1.17-5.32) were predictors of biochemical recurrence within three years.
p16 immunostaining, along with classical features such as Gleason Score and surgical margin involvement, are significant predictors of biochemical recurrence in pT2-pT3 prostate tumors.
本研究旨在探讨p16免疫组化表达对pT2 - pT3期前列腺癌生化复发率的影响。
本研究纳入了488例行根治性前列腺切除术的pT2 - pT3期前列腺腺癌患者。在复查Gleason分级并收集社会人口统计学和临床病理数据以及最后一次会诊日期和生化复发情况后，进行p16免疫组化检测。数据采用卡方检验、Fisher精确检验和多项逻辑回归模型进行关联分析。
共432例（94.5%）病例p16呈阳性，平均阳性细胞率为37.38±27.32%，平均组织学评分2.70±2.24。共有117例（18.4%）患者在三年内出现生化复发，这与术前高PSA（p = 0.007）、手术切缘阳性（p < 0.001）、pT3分期（p < 0.001）、淋巴结受累（p < 0.001）、Gleason评分>3 + 4（p < 0.001）、p16阳性率<50%（p = 0.035）以及组织学评分p16≤3（p = 0.004）直接相关。在多变量分析中，Gleason评分>3 + 4（HR = 3.08（95%CI = 1.69 - 5.62））、手术切缘阳性（HR = 2.93（95%CI = 1.70 - 5.04））以及组织学评分p16≤3（HR = 2.49（95%CI = 1.17 - 5.32））是三年内生化复发的预测因素。
p16免疫染色与Gleason评分和手术切缘受累等经典特征一样，是pT2 - pT3期前列腺肿瘤生化复发的重要预测因素。
