Page 44 - ARNM-3-3

Advances in Radiotherapy
& Nuclear Medicine PI3K and Akt in androgen-independent PCa

intensity,” 2 for “brown granules and medium intensity,” 3. Results
and 3 for “brown granules and strong intensity.”
3.1. Clinical features
The final score was obtained by multiplying the
percentage score by the staining intensity score and was In the AIPC group, seven out of 38 patients (7/38) were
interpreted as follows: a score of 0 was considered negative, ≤60 years old, and 31 patients (31/38) were >60 years old,
1 – 3 as weak positive (+), 4 – 7 as medium positive (++), with a mean age of 66.26 ± 7.53 years. The mean PSA level
was 46.58 ng/mL: 21 patients (21/38) with PSA ≤ 20 ng/mL
and 8 – 12 as strong positive (+++).
and 17 patients (17/38) with PSA > 20 ng/mL.
2.4. Scoring and grouping In the ADPC group, four out of 38 patients (4/38) were
The Gleason grading system was employed to evaluate all ≤60 years old, and 34 patients (34/38) were >60 years old,
needle biopsy specimens. Under double-blind conditions, with a mean age of 73.21 ± 9.63 years. The mean PSA level
two senior pathologists independently reviewed the cross- was 72.40 ng/mL, in which nine patients (9/38) had PSA
sectional slides and issued pathological reports. In cases ≤ 20 ng/mL and 29 patients (29/38) had PSA > 20 ng/mL
of discrepancies, a third senior pathologist reviewed the (Table 1).
findings and provided the final pathological diagnosis. These findings suggest that the prognosis of the AIPC

The Gleason score (GS) ranges from 2 to 10: 2 – 4 group may be worse than the ADPC group. There is a
indicates high differentiation, 5 – 6 indicates moderate significant difference (p < 0.01) observed between the groups
differentiation, and 7 – 10 indicates low differentiation. regarding PSA distribution (≤20 ng/mL vs. >20 ng/mL).
Based on a comprehensive understanding of PCa Furthermore, the GS in the AIPC group is significantly
treatment and classification, the updated grading system higher than the ADPC group (mean GS = 37.208; p < 0.01)
(2015 version) divides biopsies into five prognostic (Table 1).
3
grading groups according to glandular shape, integrity, and
degree of fusion: 3.2. Histopathological features
(i) Grade group 1: GS ≤ 6; composed of well-formed, The GS in the AIPC group was generally high, with all
individually separated glands. 38 patients scoring above 7. Among them, 27 cases (27/38,
(ii) Grade group 2: GS 3 + 4 = 7; composed primarily of 71.1%) had a GS of 8 (grade group 4), including Gleason
well-formed glands with a small number of cribriform patterns 4 + 4, 3 + 5, and 5 + 3 = 8. In some regions,
or fused glands. cancerous tissue consisted of densely packed or cribriform
(iii) Grade group 3: GS 4 + 3 = 7; composed mainly of glands (Figure 1A), while other areas were predominantly
cribriform and fused glands, with fewer well-formed composed of poorly differentiated components lacking
glands.
(iv) Grade group 4: GS = 8 (4 + 4, 3 + 5, or 5 + 3); includes Table 1. Comparison of age, serum prostate‑specific antigen
a variety of morphologies such as cribriform, fused, or levels, and Gleason score groups between the two patient
underdeveloped glands, and tumor tissue with partial groups
or no glandular differentiation.
(v) Grade group 5: GS 9 – 10; characterized by the absence Index AIPC ADPC Statistic p‑value
of glandular structures (or presence of necrosis), with Age
or without glandular dysplasia, or the presence of ≤60 7 4 0.957 0.328
fused and cribriform glands. >60 31 34
Prostate-specific antigen (ng/mL)
2.5. Statistical analysis
≤20 21 9 7.930 0.005
SPSS 19.0 software (IBM, United States) was used for data >20 17 29
analysis, focusing on correlations between age, clinical Gleason group
indicators, and molecular marker expression. Continuous
data are presented as mean ± standard deviation, and non- 1 0 5 37.208 <0.001
parametric rank sum tests were used for comparison of 2 0 11
grade data. Categorical data are expressed as the number 3 0 7
of cases (percentage), and comparisons between the two 4 27 7
groups were performed using the chi-squared (χ ) test or 5 11 8
2
Fisher’s exact test. A p-value of p < 0.05 was considered Abbreviations: ADPC: Androgen-dependent prostate cancer;
statistically significant. AIPC: Androgen-independent prostate cancer.

Volume 3 Issue 3 (2025) 36 doi: 10.36922/ARNM025160018