Interesting data on PCa-DNA-ploidity from Uro-Cor posted by Dr. Strum

There is much evidence that the ploidity of the DNA of PCa cells do effect ones response to hormone therapies and prognosis's of disease, the worse the ploidity gets, away from normal cell DNA strands that are similar to diploid (two sets of chromosomes matched), others get into uneven sets and randomish like chaos thus aneuploid and it used to be mentioned a third worst level was named teteraploid (spelling) or such, perhaps that has been dropped and leaving the two categories presently seen in this data collected from Uro-Cor. It is best to be found with diploid cells, you can pay expert pathologists like Bostwick, Oppenheimer and a few others an additional fee to have this done, Dr. Epstein does not apparently believe alot in the value of ploidity and does not offer it  (not making any judgement on him either).

Gleason Score vs Probability of Diploid vs Aneuploid

GS         Diploid        Aneuploid        # Biopsies Evaluated

2-5        85%            15%                    564
6            62%            38%                   15,999
7            33%            67%                   12,768
8            22%            78%                   4,433
9-10      13%            87%                   2,167

See Insights, Vol 4, No.1 Jan 2001, page 4, table 2.
Data from UroCor, Inc.

Dr. Strum had this in reference to a patient on P2P question/answers thing from prostate-pointers.org ,  which was just replied to on the internet and so I thought others should atleast ponder these collected datas on PCa, it is very significant that high gleasons are associated with riskier level of ploidity analysis and those same patients have usually more issues with control of the disease via drug therapies or perhaps any therapy. Why ploidity is not done as standard practice on biopsies is in my mind, stupid. We spend a fortune on unneeded ct and bone scans on low stats patients, which costs alot of money and is a complete waste of resources (as per Dr. Strum mentioning the same). But don't have money for say a few hundred more bucks for ploidity analysis???? 

I would have thought in my own mind that Gleason 6's in general were higher percentages of diploid status, maybe  85-95% and herein shows 62% in a rather decent patient sampling, interesting.  May not surprise me though, as PCa is just so unpredictable to know where a patient stands, even some low stats patients fail cures (maybe not that many?) This may help to explain why and also who knows if your PCa type is properly identified to begin with, 18 variants types of PCa have been found...I doubt the average pathologist knows what he is looking at compared to the leading experts in this (that is my own thoughts).  I think the variants thing is swept under the rug, you might ask your uro-doc how many variants of PCa are there or what is ploidity analysis (gulp...probably unaware), or are there some weird variants of PCa and if so, can you name a few of them????  (like: small cell, signet ring, squamous cell and such). Uro-doc should atleast know some of them  like maybe, small cell  PCa which does have a terrible prognosis in general.

Chow-

I noticed this data was created in 2001.  Not many people realize this, but in 2005 there was a change to the Gleason grading system.

See this article.

http://www.nature.com/nrurol/journal/v7/n3/full/nrurol.2010.9.html

Since 2005 it is a lot harder to be a Gleason 6 then before.  If you look at the chart Gleason 6 looks more like  Gleason 5 used to.  Thus some of you guys who are Gleason 7 today may have been Gleason 6 before 2005.  Read the whole article, but it appears that Johns Hopkins has adopted this and I believe many others.  This would shift the DNA polity results.

I think it makes the Gleason 6 people have a much better prognosis.  According to J.H. if you have organ confined Gleason 6 you are basically cured by surgery alone.  They have a 99.6% cure rate for RRP Gleason 6.  The other .4% after 22 years did not even develope metastatic desease...This has still ruined what's left of my life...

David the basic idea on this is to understand risk factors as to ploidity pointing towards higher (or lower) risk with Aneuploid level=higher (the DNA strands are not well differentiated(definable) or in a pairs as in normal type cell structures with the pairs of chromosomes (normal cells 23 pairs=46 chromosomes matched up), this level they are more chaotic and unevenedly paired, etc.). Means ones disease risk is higher as to becoming refractory (refractive) on drug therapys (they stop working perhaps sooner), and controlling of the PCa. So, as you look at the high Gleason scores 9,10's the odds for having the better type of diploid type cell structures are low, also you see more patients dealing with high risk scenarios. It may be useful to know such information up front or when dealing with some of the excellent onco-docs, whom look at this type of information and could perhaps find it useful in forming their strategies for protocols on patients(they do things uro-docs never heard of) and this is why patients seek them out. Don't freak out on this information or let it scare you, was intended as educational useage and demonstration.

I have seen ploidy analyses in three categories: Diploid (normal), tetraploid (double), and aneuploid (abnormal numbered). This Strum article mentions only two. What happened to the tetraploid? Or might the aneuploid be re-named "non-diploid"?

Post Edited (tarhoosier) : 6/23/2010 8:19:35 AM (GMT-6)

Special Notation to Ohio State:

Why don't you come out to "chat time" this evening, and chill out with some of the guys and girls, its a good outlet. You don't have to even talk about PC, though we often do. You can talk about anyting you wish or interests you. The group on the chat switches interests and subjects often. Just a good time to chill out with the brethren, since we can't just meet up at a local bar or pub and shoot the breeze. You would be most welcomed.

David in SC