Quantitative morphometric analysis of the microcirculation in prostate carcinoma.

Many neoplasms have been shown to induce capillary neovascularization and this may correlate with aggressive behavior. We investigated the phenomenon of neovascularity in benign and malignant prostatic tissue. Microvessel profiles and tissue sections were visualized by antibodies to Factor VIII and standard immunohistochemical techniques, and quantified utilizing the Optimas computerized image analysis system. Microvessel density was compared in benign and cancerous portions of 15 radical prostatectomy specimens. Fourteen of 15 cases demonstrated significantly higher vascular density in the area of carcinoma as compared with benign tissue (ratio = 2.02, p < 0.001). Distribution of microvessels within malignancy was random, whereas it was restricted primarily to the periglandular space in benign tissue. Among 20 men undergoing radical retropubic prostatectomy, there was a correlation between the vessel density and the pathologic stage. No patient with organ-confined carcinoma or cancer penetrating (but not perforating) the capsule had microvessel density greater than 156 microvessels/mm2. In contrast, six of 15 men with more advanced pathologic stage exceeded this arbitrary threshold. These data demonstrate both increased vascularity of prostatic carcinoma as compared with benign tissue, and a further correlation between pathologic stage and vascularity. Microvessel density may be useful as a prognostic indicator.