Can the presence of hyaluronidase predict risk for progression?


A key goal of the prostate cancer research community has been the identification of markers that could help us to better identify patients at high risk for prostate cancer progression as early as possible in the disease process. It now appears that the presence of an enzyme called HYAL-1 hyaluronidase and hyaluronic acid staining in prostatectomy specimens may be able to do this.

It has previously been shown that HYAL-1 hyaluronidase and hyaluronic acid staining in prostatectomy specimens predicts for risk of biochemical recurrence. In the current study, Gomez et al. investigated whether hyaluronic acid and HYAL-1 staining in biopsy specimens predicts for risk of biochemical recurrence and correlates with staining in matched prostatectomy specimens.

The authors used specimens from 61 patients with clinically localized prostate cancer from multiple centers, including 23 with biochemical recurrence (Group 1) and 38 without biochemical recurrence (Group 2). The mean patient follow-up was 103.1 months.

The results of the study showed the following:

  • HYAL-1 and hyaluronic acid were expressed in tumor cells and in stroma, respectively.
  • In biopsy specimens, HYAL-1 and hyaluronic acid expression was higher in Group 1 than in Group 2 (203.9 and 182.1 vs 48.8 and 87.0, respectively, p < 0.0001).
  • On univariate analysis, hyaluronic acid, HYAL-1, biopsy Gleason score, and PSA level each significantly predicted biochemical recurrence (p < 0.001).
  • On multivariate analysis only HYAL-1 staining independently predicted recurrence, with an accuracy of 81.8 percent (p < 0.001).
  • In prostatectomy specimens only HYAL-1 staining correlated with staining in biopsy specimens and predicted biochemical recurrence.

The authors comment that, to their knowledge, “this is the first report that HYAL-1 staining in biopsy specimens is an independent predictor of biochemical recurrence.”

The “New” Prostate Cancer InfoLink considers that this may be a very important finding. However, the current study is small, the abstract does not give information on false positive or false negative results, and the finding would clearly need to be replicated in larger and more detailed studies before we could consider HYAL-1 staining of biopsy cores as a possible predictor for risk of progressive prostate cancer.

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