Thesis is devoted to improvement of the morphological criteria of prognosis and differential diagnosis of prostate cancer (PC) by studying the morphological features, immunohistochemical markers, and significance of the stromal component in the molded aggressive phenotype of tumor. The basis of morphological and molecular studies thesis have made histological specimens of 112 cases of PC, 25 cases of nodular prostatic hyperplasia (NPH), 25 cases of prostatic intraepithelial neoplasia (PIN). It was found that in the structure of surgical prostate pathology of the Kharkiv region for 2011-2015 (7280 cases) cancers make up 19,6 % (886) and 58,1 % (1608/2766) of the total number of biopsies. In thesis based on a study of the stroma and with taking into account the complex of clinical and morphological features is defined morphological criteria of PC, NPH, and PIN and feathers of probable aggressive behavior, favorable prognosis and do not affect the clinical course. Supplemented scientific data about the features and prognostic value of epithelial-mesenchymal transformation (EMT) in PC. It is shown that PC with Gleason score (GS) 8 mostly have the appearance of vimentin expression in cancer cells (p < 0.01), while PC with GS 9-10 associated within creased expression of E-cadherin; also it is proved the relationship between expression of these markers and accessoring to risk groups of PC. It is shown the unity of molecular biology features of EMT and role in its process TGF-в. It was proved the involvement of CD68+ cells in the process of EMT and in realization of the aggressive phenotype of PC. The favorable morphological prognostic criteria of PC are: low level of PSA in blood (less than 10 ng/ml), low proliferative activity (Ki-67 less than 1 %), absence of desmoplasia. The signs of possible aggressive clinical behavior of PC include level of PSA more than 20 ng/ml, increase of proliferative activity (Ki-67 more than 1 %), immunohistochemical evidence of EMT, increase in number of microvessels and decrease their area, high level of infiltration by macrophages (CD68+). Do not have a significant predictive value: age of patients, pronounced desmoplasia, expression of cytokeratin 8/18, TGF-B, SMA-alpha, VEGF, degree of immune-cell infiltration and absolute number of CD3+, CD8+, CD4+, CD20+ cells. For differential diagnosis between benign prostate pathology and PC the reliable criteria are the investigation of p63 and high molecular weight cytokeratin HMW.
