1. ¹Department of Urology, Örebro University Hospital, Örebro 701 85, Sweden
2. ²Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 77, Sweden
3. ³Department of Pathology, Brigham and Womens Hospital, Boston, MA 02215, USA
4. ⁴Department of Pathology, Örebro University Hospital, Örebro 701 85, Sweden
5. ⁵Department of Medicine, Channing Laboratory, Harvard Medical School/Brigham and Women's Hospital, Boston, MA 02215, USA
6. ⁶Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA

Correspondence: Dr O Andrén, E-mail: ove.andren@orebroll.se

Received 2 April 2007; Revised 29 June 2007; Accepted 20 July 2007; Published online 28 August 2007.

Abstract

Anti-adhesion mucins have proven to play an important part in the biology of several types of cancer. Therefore, we test the hypothesis that altered expression of MUC-1 is associated with prostate cancer progression. We retrieved archival tumour tissue from a population-based cohort of 195 men with localised prostate cancer (T1a-b, Nx, M0) that has been followed for up to 20 years with watchful waiting. Semi-automated, quantitative immunohistochemistry was undertaken to evaluate MUC-1 expression. We modelled prostate cancer-specific death as a function of MUC-1 levels accounting for age, Gleason grade and tumour extent, and calculated age-adjusted and multivariate adjusted hazard ratios (HR). Men that had tumours with an MUC-intensity lower or higher than normal tissue had a higher risk of dying in prostate cancer, independent of tumour extent and Gleason score (HR 5.1 and 4.5, respectively). Adjustment for Gleason grade and tumour stage did not alter the results. Men with a Gleason score 7 and MUC-1 deviating from the normal had a 17 (RR=17.1 95% confidence interval=2.3–128) times higher risk to die in prostate cancer compared with men with Gleason score <7 and normal MUC-1 intensity. In summary, our data show that MUC-1 is an independent prognostic marker for prostate cancer death.