Prostate specific antigen and prostatic acid phosphatase immunoreactivity as prognostic indicators of advanced prostatic carcinoma.

To determine whether the prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) immunoreactivities in prostatic carcinoma are reliable prognostic factors, the PSA and PAP immunohistochemical distribution was examined in needle biopsy specimens of 80 patients with advanced prostatic carcinoma. Our results indicated a higher cancer-specific survival rate in patients with a greater PSA or PAP immunostaining. Furthermore, a multivariate analysis of possible prognostic factors, that is patient age, clinical stage, Gleason score, serum PAP, PSA and PAP immunostaining scores, and the initial treatment, has confirmed that the difference in PAP immunoreactivity is the most important prognostic factor (p < 0.01) for advanced prostatic carcinoma, with the Gleason score (p = 0.06), clinical stage (p = 0.09) and PSA immunoreactivity (p = 0.48) being the second, third and fifth prognostic factors, respectively.