Follow-up of prostate carcinoma patients treated with total androgen blockade by repeated map-biopsy

A prospective study was carried out on ten patients with prostate cancer. The TNM stage, Gleason's grade, general clinical status and, serum PSA level were all registered by the time of diagnosis. Total androgen blockade (TAB) was performed. Serum PSA control and general clinical examination re-biopsy was performed on average 107 days after the start of the therapy. The pre- and post treatment histology included HE and Tunel reaction to show apoptotic cells, as well as p53, bcl2 and Ki67 immunostaining. Clinical improvement of the disease, manifested by regression or by steady state was observed in all ten patients. An increase of apoptotic index, and a decrease of mitotic index was detected in most cases. The serum PSA level decreased in all patients. Ki67, bcl2 and mutant p53 were strongly expressed in tumor cells of patients in whom Gleason's grade was 7 or higher and decreased markedly in all cases upon therapy. Data obtained by repeated biopsy in the course of TAB therapy are indicators of the effectiveness of TAB, like changes in serum PSA, and may be considered as predictive factors.