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Tumor Biology |
Scott Department of Urology [S. S., G. Y., S. E., A. F., T. C. T.] and Departments of Pathology [T. M. W.], Cell Biology [T. C. T.], and Radiology [T. C. T.], Baylor College of Medicine, Houston, Texas 77030
Tumor-associated macrophages (TAMs) are highly active immune effector
cells that may either positively or negatively regulate the growth of
various malignant cells, depending on the biological context. However,
the role of TAMs in human prostate cancer progression is unclear. TAMs
were immunohistochemically labeled using a monoclonal (CD68) antibody
in radical prostatectomy specimens derived from 81 prostate cancer
patients. CD68-positive cells were counted with the aid of a microscope
and expressed as macrophage index (M
I), including
TAMs/mm2 total tumor tissue
(M
Itotal),
TAMs/mm2 tumor stroma
(M
Istroma),
and TAMs/mm2 cancer cell area
(M
Icancer).
M
Is were analyzed in association with patients
clinical and pathological stage, recurrence status, and histological
grade of the cancer. There were significant inverse relationships
between
M
Itotal
and
M
Istroma
and clinical stage (P = 0.016 and
P = 0.006, respectively). Reduced
M
Itotal
was also associated with the presence of positive lymph nodes
(P = 0.010). Interestingly, although all
of the M
Is differed between Gleason score groups, only
M
Icancer
was positively associated with Gleason score. Univariate analysis of
M
Itotal
and multivariate analysis of
M
Itotal
with specific pathological markers revealed that
M
Itotal
was an independent predictor for disease-free survival after surgery
(Cox proportional hazard model, P = 0.044
and P = 0.007, respectively). For
patients with high
M
Itotal
(
185.8, the mean
M
Itotal
value), the disease-free probability 5 years after surgery was 0.75,
which was significantly higher than for those with low
M
Itotal
(0.31, P = 0.0008). Additional
immunohistochemical studies that evaluated cytotoxicity-related
biomarkers in stroma-associated mononuclear cells suggested reduced
functional activities in highly aggressive prostate cancer compared
with less aggressive disease. Our results indicate that reduced
M
Itotal
is a novel prognostic marker for prostate cancer.
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