Prostate cancer: Relationship between vascular diameter, shape and density and Gleason score in needle biopsy specimens

BACKGROUND: Tumor growth requires expansion and development of vascular network. An increase in Gleason score is representative of an increase in tumor invasion and extent. In this study, the relationship between Gleason score and vascular characteristics of needle biopsy samples in prostate cancer patients has been evaluated. MATERIALS AND METHODS: We evaluated vascular characteristics including density and size of vessels; and percentage of vessels with irregular shape in 62 cancer-positive samples obtained by prostate needle biopsy under ultrasound guide, and compared them to Gleason score. RESULT: Gleason scores of 23 patients were ≤6; Gleason scores of 18 patients were 7 and 21 patients had their Gleason score from 8 to 10. An increase in Gleason score was associated with increased vascular density (P < 0.0001), increased percentage of vessels with irregular shape (P < 0.02) and decreased average vascular diameter (P < 0.015), from which the relationship with vascular density was clearer and more evident. CONCLUSION: Vascular morphological characteristics can be representative of angiogenic potential of prostate cancer which is required for tumor progression. As Gleason score can prognosticate the behavioral characteristics of prostate cancer in future, vascular characteristics may also be able to express tumor behavior. With attention to vascular characteristics in biopsy samples and apart from Gleason score, we may also be able to divide patients into other subtypes in a way being helpful for the establishment of treatment plan.