CRIS P-3 and β-MS P on prostate cancer needlebiopsies do not have predictive value for subsequent prostatectomy outcome

Introduction & Objectives: Tissue expression of cysteine-rich secretory protein 3 (CRISP-3) and β-microseminoprotein (β-MSP) have an independent predictive value for biochemical recurrence after radical prostatectomy (RP) for prostate cancer (PC). It is not known whether CRISP-3 and β-MSP also have prognostic value in diagnostic prostate needle-biopsies. In the current study we have investigated expression levels and prognostic value of both markers in diagnostic biopsies, in order to evaluate their potential clinical implementation in a preoperative setting. Materials & Methods: A total of 174 participants of the European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam section, with PC and treated by RP were included in this study. CRISP-3 and β-MSP immunohistochemistry was performed on corresponding diagnostic needle-biopsies. Outcome was correlated with clinico-pathologic parameters (PSA, number of positive biopsies; Gleason score (GS), pT3/ 4 and surgical margins at RP) and significant PC at RP (pT3/ 4, or GS > 6, or tumour volume ≥0.5 ml) in the total cohort (n=174) and in a subgroup with low-risk features at biopsy (PSA ≤10 ng/ml, cT ≤2, PSA density <0.20 ng/ml/g, GS <7 and ≤2 positive biopsy cores; (n=87)). Results: β-MSP and CRISP-3 expression in PC tissue was heterogeneous with variable levels of intensity occurring in the same tissue specimens. While high expression of β-MSP significantly correlated with GS <7 at RP, it was not a predictor for significant PC at RP neither in the total group (n=174; OR 0.319; 95%CI 0.060-1.695; p=0.180) nor in the low-risk group (n=87; OR 0.227; 95% CI 0.040-1.274; p=0.092). CRISP-3 expression was not related with clinico-pathologic parameters, and did not predict significant PC at RP in the total group (n=174; OR 1.056; 95% CI 0.438-2.545; p=0.904) or the low-risk group (n=87; OR 1.856; 95% CI 0.626-5.506; p=0.265). Conclusions: Decreased β-MSP expression correlated with high GS in subsequent RP tissue specimens supporting the view that β-MSP exerts a tumour-suppressive effect. We were not able to find a significant prognostic value of β-MSP or CRISP-3 in prostate needle-biopsies for significant PC at RP. Therefore, β-MSP or CRISP-3 do not seem to have additional value in therapeutic stratification of PC patients.