Prognostic Potential of Androgen Receptor Expression in Prostate Cancer: A Crosssectional Immunohistochemical Study

Introduction: Androgen Receptors (AR) play a crucial role in prostate cancer pathogenesis, which drives tumour growth and progression. High AR expression has been linked to tumour aggressiveness. However, its prognostic significance remains underexplored in the Indian population. Aim: To assess the expression of AR in prostatic adenocarcinoma and its association with established clinicopathological prognostic factors. Materials and Methods: The cross-sectional study was conducted at the Department of Pathology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India, from January 2018 to February 2020, and included 60 cases of prostate carcinoma. Using Immunohistochemistry (IHC), AR expression was evaluated and compared to established prognostic parameters, including age, Gleason score and grade, preoperative serum Prostate-specific Antigen (PSA) levels, and perineural invasion. The associations between parameters were assessed by performing Pearson’s Chisquare test using Statistical Package for the Social Sciences (SPSS) version 24.0. A p-value <0.05 indicated statistical significance. Results: A total of 60 patients with prostatic adenocarcinoma, aged between 41 and 84 years (mean age=69.05 years), were included in the study. Preoperative serum PSA levels ranged from 6.8 to 157 ng/mL. High AR expression was observed in a considerable number of instances (45 cases; 75%), especially in tumours exhibiting aggressive histopathological characteristics. AR expression demonstrated a statistically significant association with high Gleason scores (p-value=0.002) and Gleason grade (p-value <0.001) (34/45 high AR expression cases; 75.6% belonged to a total Gleason score of ≥9 and a grade of 5). Conversely, no association was identified between AR expression and age (p-value=0.086), preoperative serum PSA levels (p-value=0.398), or perineural invasion (p-value=0.09). Conclusion: High AR expression is markedly associated with aggressive histopathological characteristics in prostatic carcinoma, underscoring its potential as a prognostic indicator. Subsequent research may confirm AR as a target for therapeutic strategies in high-risk prostate cancer cases.