학술논문

Comprehensive validation of published immunohistochemical prognostic biomarkers of prostate cancer-what has gone wrong? A blueprint for the way forward in biomarker studies.
Document Type
Article
Source
British Journal of Cancer. 1/6/2015, Vol. 112 Issue 1, p140-148. 9p. 1 Color Photograph, 4 Charts, 2 Graphs.
Subject
*BIOMARKERS
*PROSTATE cancer prognosis
*PROSTATE cancer treatment
*PROSTATE cancer
*PROSTATECTOMY
*IMMUNOSTAINING
*IMMUNOHISTOCHEMISTRY
*MEDICAL publishing
Language
ISSN
0007-0920
Abstract
Background:Treatment planning of localised prostate cancer remains challenging. Besides conventional parameters, a wealth of prognostic biomarkers has been proposed so far. None of which, however, have successfully been implemented in a routine setting so far. The aim of our study was to systematically verify a set of published prognostic markers for prostate cancer.Methods:Following an in-depth PubMed search, 28 markers were selected that have been proposed as multivariate prognostic markers for primary prostate cancer. Their prognostic validity was examined in a radical prostatectomy cohort of 238 patients with a median follow-up of 60 months and biochemical progression as endpoint of the analysis. Immunohistochemical evaluation was performed using previously published cut-off values, but allowing for optimisation if necessary. Univariate and multivariate Cox regression were used to determine the prognostic value of biomarkers included in this study.Results:Despite the application of various cut-offs in the analysis, only four (14%) markers were verified as independently prognostic (AKT1, stromal AR, EZH2, and PSMA) for PSA relapse following radical prostatectomy.Conclusions:Apparently, many immunohistochemistry-based studies on prognostic markers seem to be over-optimistic. Codes of best practice, such as the REMARK guidelines, may facilitate the performance of conclusive and transparent future studies. [ABSTRACT FROM AUTHOR]