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[Cancer Research 60, 5857-5861, October 15, 2000]
© 2000 American Association for Cancer Research


Tumor Biology

Reduced Infiltration of Tumor-associated Macrophages in Human Prostate Cancer: Association with Cancer Progression1

Satoru Shimura, Guang Yang, Shin Ebara, Thomas M. Wheeler, Anna Frolov and Timothy C. Thompson2

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{phi}I), including TAMs/mm2 total tumor tissue (M{phi}Itotal), TAMs/mm2 tumor stroma (M{phi}Istroma), and TAMs/mm2 cancer cell area (M{phi}Icancer). M{phi}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{phi}Itotal and M{phi}Istroma and clinical stage (P = 0.016 and P = 0.006, respectively). Reduced M{phi}Itotal was also associated with the presence of positive lymph nodes (P = 0.010). Interestingly, although all of the M{phi}Is differed between Gleason score groups, only M{phi}Icancer was positively associated with Gleason score. Univariate analysis of M{phi}Itotal and multivariate analysis of M{phi}Itotal with specific pathological markers revealed that M{phi}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{phi}Itotal (>=185.8, the mean M{phi}Itotal value), the disease-free probability 5 years after surgery was 0.75, which was significantly higher than for those with low M{phi}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{phi}Itotal is a novel prognostic marker for prostate cancer.




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