Large-Gland Proliferations of the Prostate

Large-gland proliferations of the prostate have gained considerable attention in the past decade. The differential diagnosis is quite broad but can be refined using histologic criteria and, sometimes, immunostains. Pathologists have come to realize that cribriform and intraductal as well as ductal carcinomas are particularly aggressive patterns, and should name them in diagnostic reporting when present.

Abstract 539: Pro-proliferative function of the histone deacetylase SIRT3 in prostate cancer

Worldwide, prostate cancer (PCa) is the second most frequently diagnosed cancer and fifth leading cause of cancer death in males. The existing treatments, as well as surgical approaches, have not been fully effective either for prevention or treatment of PCa. This necessitates a need to intensify our efforts towards the understanding of genetics and mechanism(s) of PCa. This may lead to the identification of the novel molecular target(s) and mechanism-based approaches for the management of this neoplasm. Sirtuin-3 (SIRT3) is a nicotinamide adenine dinucleotide (NAD)-dependent deacetylase primarily located in the mitochondria and known to play important roles in the regulation of a variety of cellular processes, including transcription and programmed cell death. The fact that SIRT3 can regulate several cellular processes those are critical in cancer cell proliferation, makes it a potential therapeutic target for cancer management. Moreover, SIRT3 is a central regulator of mitochondrial adaptive responses that relate to metabolic reprogramming of cancer cells. However, the role of SIRT3 in cancer, including PCa, is not well understood and it has been shown to act both as a tumor suppressor as well as a tumor promoter. In this study, we determined the role of SIRT3 in PCa, employing in vitro and ex vivo approaches. The first step in our efforts to understand the role of SIRT3 in PCa was to check the expression profile of SIRT3 in a panel of human PCa cell line (DU145, 22Rν1, PC3, LNCaP, C4-2, MDA PCa 2b, E006AA-Par and E006AA-hT) by RT-qPCR and immunoblot analyses. Compared to normal human prostate epithelial cells (NrPEC), PCa cells showed higher expression of SIRT3, both at mRNA and protein levels. Further, we determined the expression profile of SIRT3 by immunostaining of a tissue microarray (TMA) containing paraffin-embedded sections of 40 cases of prostate adenocarcinoma and 8 normal prostate tissues. Our data demonstrated a significant upregulation of SIRT3 in cancerous prostatic tissues compared to the normal tissues. We next determined the effect of chemical inhibition of SIRT3 using a recently described SIRT3 inhibitor viz. 4'-Bromo-Resveratrol (4BR), in human PCa cells (DU145 and 22Rν1). 4BR treatment at 10, 20 and 40 μM concentrations for 48 and 72 h resulted in a dose- and time-dependent decrease in cell growth and proliferation. Further, 4BR treatment resulted in a marked decrease in clonogenic survival of DU145 and 22Rν1 PCa cells. Furthermore, 4BR treatment resulted in a marked cleavage of PARP, an indicator of apoptosis induction; and a decrease in the level of PCNA, a marker of cellular proliferation, in human PCa cells. Overall, our data suggest a possible pro-proliferative function of SIRT3 in PCa. Further studies are underway to unravel the role and functional significance of SIRT3 during PCa development and progression.

Citation Format: Chandra K. Singh, Gagan Chhabra, Minakshi Nihal, Kenneth A. Iczkowski, Nihal Ahmad. Pro-proliferative function of the histone deacetylase SIRT3 in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 539.

Radio-pathomic Maps of Epithelium and Lumen Density Predict the Location of High-Grade Prostate Cancer

PURPOSE

This study aims to combine multiparametric magnetic resonance imaging (MRI) and digitized pathology with machine learning to generate predictive maps of histologic features for prostate cancer localization.

METHODS AND MATERIALS

Thirty-nine patients underwent MRI prior to prostatectomy. After surgery, tissue was sliced according to MRI orientation using patient-specific 3-dimensionally printed slicing jigs. Whole-mount sections were annotated by our pathologist and digitally contoured to differentiate the lumen and epithelium. Slides were co-registered to the T2-weighted MRI scan. A learning curve was generated to determine the number of patients required for a stable machine-learning model. Patients were randomly stratified into 2 training sets and 1 test set. Two partial least-squares regression models were trained, each capable of predicting lumen and epithelium density. Predicted density values were calculated for each patient in the test dataset, mapped into the MRI space, and compared between regions confirmed as high-grade prostate cancer.

RESULTS

The learning-curve analysis showed that a stable fit was achieved with data from 10 patients. Maps indicated that regions of increased epithelium and decreased lumen density, generated from each independent model, corresponded with pathologist-annotated regions of high-grade cancer.

CONCLUSIONS

We present a radio-pathomic approach to mapping prostate cancer. We find that the maps are useful for highlighting high-grade tumors. This technique may be relevant for dose-painting strategies in prostate radiation therapy.

Utility of Pathology Imagebase for standardisation of prostate cancer grading

AIMS

Despite efforts to standardise grading of prostate cancer, even among experts there is still a considerable variation in grading practices. In this study we describe the use of Pathology Imagebase, a novel reference image library, for setting an international standard in prostate cancer grading.

METHODS AND RESULTS

The International Society of Urological Pathology (ISUP) recently launched a reference image database supervised by experts. A panel of 24 international experts in prostate pathology reviewed independently microphotographs of 90 cases of prostate needle biopsies with cancer. A linear weighted kappa of 0.67 (95% confidence interval = 0.62-0.72) and consensus was reached in 50 cases. The interobserver weighted kappa varied from 0.48 to 0.89. The highest level of agreement was seen for Gleason score (GS) 3 + 3 = 6 (ISUP grade 1), while higher grades and particularly GS 4 + 3 = 7 (ISUP grade 3) showed considerable disagreement. Once a two-thirds majority was reached, images were moved automatically into a public database available for all ISUP members at www.isupweb.org. Non-members are able to access a limited number of cases.

CONCLUSIONS

It is anticipated that the database will assist pathologists to calibrate their grading and, hence, decrease interobserver variability. It will also help to identify instances where definitions of grades need to be clarified.

Investigation of Physical Phenomena Underlying Temporal-Enhanced Ultrasound as a New Diagnostic Imaging Technique: Theory and Simulations

Temporal-enhanced ultrasound (TeUS) is a novel noninvasive imaging paradigm that captures information from a temporal sequence of backscattered US radio frequency data obtained from a fixed tissue location. This technology has been shown to be effective for classification of various in vivo and ex vivo tissue types including prostate cancer from benign tissue. Our previous studies have indicated two primary phenomena that influence TeUS: 1) changes in tissue temperature due to acoustic absorption and 2) micro vibrations of tissue due to physiological vibration. In this paper, first, a theoretical formulation for TeUS is presented. Next, a series of simulations are carried out to investigate micro vibration as a source of tissue characterizing information in TeUS. The simulations include finite element modeling of micro vibration in synthetic phantoms, followed by US image generation during TeUS imaging. The simulations are performed on two media, a sparse array of scatterers and a medium with pathology mimicking scatterers that match nuclei distribution extracted from a prostate digital pathology data set. Statistical analysis of the simulated TeUS data shows its ability to accurately classify tissue types. Our experiments suggest that TeUS can capture the microstructural differences, including scatterer density, in tissues as they react to micro vibrations.

Variation in nuclear size and PD-L2 positivity correlate with aggressive chromophobe renal cell carcinoma

Chromophobe renal cell carcinoma (CRCC) is not amenable to International Society for Urologic Pathology-endorsed nucleolar grading. Novel grading approaches were proposed, but the rarity of adverse pathology hampers their discriminatory value. We investigate simple linear micrometer measurements and a proposed immunostain in CRCCs. 32 patients' CRCCs were studied: 12 adverse cases (stage pT3, recurrence, or metastasis), 15 controls (stage ≤pT2, no recurrence or metastasis after >3 years), and 8 metastases (3 were paired with primary adverse cases). The ratio of greatest dimensions of largest and smallest nuclei, in each of 5 "worst" high-power fields, excluding those with degenerative features, was designated variation in nuclear size (VNS). Percent multinucleate cells (PMC) were also counted. Mouse anti PD-L2 monoclonal antibody immunostaining was performed. Mean VNS measured in adverse primary and control primary tumors were 3.7 ± 0.5 and 2.4 ± 0.4 respectively (P < .001), and 3.4 ± 0.4 for metastases (P < .001). Optimal VNS cut-off was 2.5, with sensitivity and specificity 0.85 and 0.81, respectively. PMCs were 6.0 ± 3.0 for adverse group, 5.7 ± 2.7 for controls, and 4.1 ± 1.6 for metastases (P = NS). PD-L2 could not discriminate adverse versus good primary tumors (χ²1.6, P = .2), but was higher in metastases (χ² 6.9, P < .01), or metastases plus adverse primary tumors (χ² 4.8, P = .03), compared to good-pathology primary tumors. In conclusion, VNS is an easily obtained measurement that can predict adverse behavior of chromophobe RCC, and may impart value for needle biopsy reporting and the choice of active surveillance. PD-L2 was elevated in metastases but was less useful for primary tumors.

Optimized b-value selection for the discrimination of prostate cancer grades, including the cribriform pattern, using diffusion weighted imaging

Multiparametric magnetic resonance imaging (MP-MRI), including diffusion-weighted imaging, is commonly used to diagnose prostate cancer. This radiology–pathology study correlates prostate cancer grade and morphology with common b-value combinations for calculating apparent diffusion coefficient (ADC). Thirty-nine patients undergoing radical prostatectomy were recruited for MP-MRI prior to surgery. Diffusion imaging was collected with seven b-values, and ADC was calculated. Excised prostates were sliced in the same orientation as the MRI using 3-D printed slicing jigs. Whole-mount slides were digitized and annotated by a pathologist. Annotated samples were aligned to the MRI, and ADC values were extracted from annotated peripheral zone (PZ) regions. A receiver operating characteristic (ROC) analysis was performed to determine accuracy of tissue type discrimination and optimal ADC b-value combination. ADC significantly discriminates Gleason (G) G4-5 cancer from G3 and other prostate tissue types. The optimal b-values for discriminating high from low-grade and noncancerous tissue in the PZ are 50 and 2000, followed closely by 100 to 2000 and 0 to 2000. Optimal ADC cut-offs are presented for dichotomized discrimination of tissue types according to each b-value combination. Selection of b-values affects the sensitivity and specificity of ADC for discrimination of prostate cancer.

Detection and grading of prostate cancer using temporal enhanced ultrasound: combining deep neural networks and tissue mimicking simulations

PURPOSE  : Temporal Enhanced Ultrasound (TeUS) has been proposed as a new paradigm for tissue characterization based on a sequence of ultrasound radio frequency (RF) data. We previously used TeUS to successfully address the problem of prostate cancer detection in the fusion biopsies. METHODS  : In this paper, we use TeUS to address the problem of grading prostate cancer in a clinical study of 197 biopsy cores from 132 patients. Our method involves capturing high-level latent features of TeUS with a deep learning approach followed by distribution learning to cluster aggressive cancer in a biopsy core. In this hypothesis-generating study, we utilize deep learning based feature visualization as a means to obtain insight into the physical phenomenon governing the interaction of temporal ultrasound with tissue. RESULTS  : Based on the evidence derived from our feature visualization, and the structure of tissue from digital pathology, we build a simulation framework for studying the physical phenomenon underlying TeUS-based tissue characterization. CONCLUSION  : Results from simulation and feature visualization corroborated with the hypothesis that micro-vibrations of tissue microstructure, captured by low-frequency spectral features of TeUS, can be used for detection of prostate cancer.

Metastatic sarcomatoid renal cell carcinoma manifesting as a subcutaneous soft tissue mass

Metastases from visceral malignancies to subcutaneous soft tissues are relatively rare and their diagnosis requires a high level of suspicion. It is even more challenging if a metastatic lesion shows non-specific high-grade spindle cell morphology overlapping with various primary cutaneous and soft tissue tumors. We describe a unique case of subcutaneous metastasis of sarcomatoid renal cell carcinoma which was the first manifestation of the occult malignancy. The patient had a history of lipomas and dysplastic nevi and presented with an upper back mass. The mass, located superficially within the subcutis, was composed of atypical spindle cells arranged in a storiform pattern. By immunohistochemistry, the tumor cells were strongly diffusely positive for cytokeratin AE1/AE3 and vimentin and negative for Melan-A, S-100 protein, SOX10, melanoma cocktail, epithelial membrane antigen (EMA), p63, CK7, CK18, CK20, smooth muscle actin (SMA), desmin, CD34, TTF-1, CD21, CD99 and bcl-2. Scattered tumor cells were positive for MDM2 immunostain, but MDM2 amplification was not detected using fluorescent in situ hybridization (FISH). Co-expression of cytokeratin and vimentin by the tumor raised the possibility of metastatic renal cell carcinoma and positivity of the tumor for PAX8 supported this hypothesis. A large renal mass was detected radiologically and the subsequent nephrectomy specimen showed high-grade clear cell renal cell carcinoma with sarcomatoid features.

Abstract 4139: Role of zinc transporters in prostate cancer and a potential association with racial disparity

Optimal intracellular zinc concentration is essential for many cellular functions as it serves as a catalytic and/or structural cofactor for a variety of proteins. Although, a number of proteins are tangled in regulating cellular zinc homeostasis, the most important are two protein families of zinc transporters, 14 members of solute carrier family 39 (SLC39A) and 10 members of solute carrier family 30 (SLC30A). These two families are known to transport zinc into- and out of- the cytoplasm, respectively. Prostate cells accumulate a high amount of zinc to sustain a metabolic condition unique to the prostate which is characterized by a truncation of the Krebs cycle and production of high amounts of citrate. Zinc depletion has frequently been noted in the progression of prostate cancer (PCa). Whether zinc transporters are a steering cause of zinc depletion in PCa development and progression and/or are key determinants in the racial disparity in PCa is not well studied. In this study, we determined the connection of zinc transporters (SLC39A 1-14 and SLC30A 1-10) in PCa, in the perspective of racial health disparity in human PCa samples taken from African-American (AA) and European-American (EA) patients and compared them with respective adjacent benign samples. We also assessed the mRNA level of zinc transporters in normal prostate epithelial cells (NrPEC and RWPE1) and among PCa cells derived from AA (MDA PCa 2b, E006AA-PAR, E006AA-HT) and EA patients (DU145, PC3, 22Rν1, LNCaP, C4-2B). In addition, we performed a dataset analysis of the Oncomine database for differential expression profile of zinc transporters in PCa versus normal prostate. We found that SLC39As mRNA levels were differentially expressed in PCa with a significant downregulation of SLC39A1, SLC39A10, SLC39A11, SLC39A13 and SLC39A14, and upregulation of SLC39A3, SLC39A5, SLC39A6 and SLC39A8. Further, SLC30As showed a significant downregulation of SLC30A5 and SLC30A6 and upregulation of SLC30A1, SLC30A9 and SLC30A10, in PCa. Further, compared to EA samples, the AA PCa showed an increasing trend of SLC39A5, SLC39A6 and SLC30A9. In addition, compared to AA samples, the EA PCa showed a trend of increasing SLC30A1 and SLC30A9 and decreasing SLC39A10. These data provide evidence that the zinc transporters may be linked to racial disparity of PCa in AA versus EA. Moreover, Ingenuity Pathway Analysis revealed regulatory interactions between zinc transporters and tumor suppressor/promoter genes proven to be modulated in PCa. These genes are HOXB13, ELAVL1, DIRAS3, ALPP, CSF2, CCL4, INSR, AKT, IL6, TGFBP1, CHI3L1, EGFR and HNF4A. Overall, our study provides interesting data about the expression profiles of zinc transporters and their interaction with tumor suppressor and promoter genes in PCa, which may offer novel strategies for the management of PCa by pharmacologically modulating zinc transporters.

Citation Format: Chandra K. Singh, Kareem M. Malas, Caitlin Tydrick, Kenneth A. Iczkowski, Nihal Ahmad. Role of zinc transporters in prostate cancer and a potential association with racial disparity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4139. doi:10.1158/1538-7445.AM2017-4139

Tissue-Specific MicroRNA Expression Patterns in Four Types of Kidney Disease

MicroRNAs contribute to the development of kidney disease. Previous analyses of microRNA expression in human kidneys, however, were limited by tissue heterogeneity or the inclusion of only one pathologic type. In this study, we used laser-capture microdissection to obtain glomeruli and proximal tubules from 98 human needle kidney biopsy specimens for microRNA expression analysis using deep sequencing. We analyzed specimens from patients with diabetic nephropathy (DN), FSGS, IgA nephropathy (IgAN), membranoproliferative GN (MPGN) (n=19-23 for each disease), and a control group (n=14). Compared with control glomeruli, DN, FSGS, IgAN, and MPGN glomeruli exhibited differential expression of 18, 12, two, and 17 known microRNAs, respectively. The expression of several microRNAs also differed between disease conditions. Specifically, compared with control or FSGS glomeruli, IgAN glomeruli exhibited downregulated expression of hsa-miR-3182. Furthermore, in combination, the expression levels of hsa-miR-146a-5p and hsa-miR-30a-5p distinguished DN from all other conditions except IgAN. Compared with control proximal tubules, DN, FSGS, IgAN, and MPGN proximal tubules had differential expression of 13, 14, eight, and eight microRNAs, respectively, but expression of microRNAs did not differ significantly between the disease conditions. The abundance of several microRNAs correlated with indexes of renal function. Finally, we validated the differential glomerular expression of select microRNAs in a second cohort of patients with DN (n=19) and FSGS (n=21). In conclusion, we identified tissue-specific microRNA expression patterns associated with several kidney pathologies. The identified microRNAs could be developed as biomarkers of kidney diseases and might be involved in disease mechanisms.

PTEN loss and p27 loss differ among morphologic patterns of prostate cancer, including cribriform

The presence and extent of cribriform pattern of prostate cancer portend recurrence and cancer death. The relative expressions within this morphology of the prognostically adverse loss of PTEN, and the downstream inactivation of cell cycle inhibitor p27/Kip1 had been uncertain. In this study, we examined 52 cases of cribriform cancer by immunohistochemistry for PTEN, p27, and CD44 variant (v)7/8, and a subset of 17 cases by chromogenic in situ hybridization (ISH) using probes for PTEN or CDKN1B (gene for p27). The fractions of epithelial pixels positive by immunohistochemistry and ISH were digitally assessed for benign acini, high-grade prostatic intraepithelial neoplasia, and 8 morphologic patterns of cancer. Immunostaining results demonstrated that (1) PTEN loss was significant for fused small acini, cribriform-central cells, small cribriform acini, and Gleason grade 5 cells in comparison with other acini; (2) p27 loss was significant only for cribriform-peripheral cells and borderline significant for fused small acini in comparison with benign acini; and (3) CD44v7/8 showed expression loss in cribriform-peripheral cells; other comparisons were not significant. ISH showed that cribriform cancer had significant PTEN loss normalized to benign acini (P<.02), whereas Gleason 3 cancer or fused small acini did not. With CDKN1B, the degree of signal loss among various cancer morphologies was insignificant. In conclusion, molecular disparities emerged between the fused small acini and cribriform patterns of Gleason 4 cancer. PTEN or p27 loss as prognostic factors demands distinct assessment in the varieties of Gleason 4 cancer, and in the biphenotypic peripheral versus central populations in cribriform structures.

Androgen receptor-dependent and -independent mechanisms driving prostate cancer progression: Opportunities for therapeutic targeting from multiple angles

Despite aggressive treatment for localized cancer, prostate cancer (PC) remains a leading cause of cancer-related death for American men due to a subset of patients progressing to lethal and incurable metastatic castrate-resistant prostate cancer (CRPC). Organ-confined PC is treated by surgery or radiation with or without androgen deprivation therapy (ADT), while options for locally advanced and disseminated PC include radiation combined with ADT, or systemic treatments including chemotherapy. Progression to CRPC results from failure of ADT, which targets the androgen receptor (AR) signaling axis and inhibits AR-driven proliferation and survival pathways. The exact mechanisms underlying the transition from androgen-dependent PC to CRPC remain incompletely understood. Reactivation of AR has been shown to occur in CRPC despite depletion of circulating androgens by ADT. At the same time, the presence of AR-negative cell populations in CRPC has also been identified. While AR signaling has been proposed as the primary driver of CRPC, AR-independent signaling pathways may represent additional mechanisms underlying CRPC progression. Identification of new therapeutic strategies to target both AR-positive and AR-negative PC cell populations and, thereby, AR-driven as well as non-AR-driven PC cell growth and survival mechanisms would provide a two-pronged approach to eliminate CRPC cells with potential for synthetic lethality. In this review, we provide an overview of AR-dependent and AR-independent molecular mechanisms which drive CRPC, with special emphasis on the role of the Jak2-Stat5a/b signaling pathway in promoting castrate-resistant growth of PC through both AR-dependent and AR-independent mechanisms.

Genomic Pathology and Cancer Biomarkers: Prostate Cancer

Our understanding of genomic pathology and biomarkers for prostate cancer is continually growing. Some promising and useful tissue markers are GSTP1, HOXD3, cell cycle proteins, chromatin remodeling proteins, androgen receptor, Stat5a/b, ERG, and PTEN. Serum and urine markers are mostly either prostate-specific antigen or newer tests using one or more other kallikreins or sarcosine. The data and evidence for all of these markers and the commercial tests using them are reviewed here.

Abstract LB-228: Polo-like kinase 4: A potential new target for the management of prostate cancer

Prostate cancer (PCa) is the most prevalent non-cutaneous cancer of males. According to an estimate from the American Cancer Society, it is expected that approximately 180,890 new cases of PCa will be diagnosed and 26,120 PCa-related deaths will occur in the United States in 2016. Therefore, identification of additional molecular target(s) could be useful in designing novel mechanism-based approaches for the prevention and/or therapy of PCa. PLK4 belongs to the polo-like kinase family of serine/threonine protein kinases that localizes to centrioles and regulates centriole duplication during the cell cycle. Essentially, PLK4 is a low abundance suicidal kinase that is known to auto-phosphorylate itself to promote its own destruction to limit centriole duplication once per cell cycle phase. Since centrosome aberrations are frequently seen in cancer, the central role of PLK4 in centriole duplication suggests its significance as a potential target for cancer management. However, the role and functional relevance of PLK4 in PCa development and progression has not been investigated. In this study, we determined the expression profile of PLK4 in PCa using immunohistochemical analysis of multiple tissue microarrays (TMAs) containing a variety of cancerous and benign human prostate tissues. The TMAs were immunostained for PLK4 and the images were scanned and analyzed for protein levels using Aperio ScanScope at 40x magnification. We found a significant upregulation of PLK4 in PCa, compared to benign prostatic tissues. Further, we found a significant upregulation of PLK4 protein and mRNA in human PCa cells, as assessed by western blot and qRT-PCR analyses, respectively. To further assess the relevance of PLK4 overexpression in PCa, we determined the effect of a small molecule inhibitor of PLK4, centrinone-B, on androgen-responsive 22Rν1 and androgen-independent DU145 human PCa cells. Centrinone-B treatment (0, 50, 100 and 200 nM; for 24 and 48 h) resulted in a marked decrease in growth and viability of PCa cells, as assessed i) by CytoTox-Glo™ cytotoxicity assay, and ii) microscopic evaluation of cells following staining with Nuclear Fast Red and Crystal Violet dyes. Further, centrinone-B treatment resulted in a G1 phase cell cycle arrest of human PCa cells. Taken together, our study provides first direct evidence of a pro-proliferative function of PLK4 in PCa. However, additional studies are required to ascertain the relevance of our in vitro findings to in vivo situations in relevant animal models.

Citation Format: Chandra K. Singh, Maria Shabbir, Minakshi Nihal, Kenneth A. Iczkowski, Nihal Ahmad. Polo-like kinase 4: A potential new target for the management of prostate cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-228.

Calcitonin Receptor-Zonula Occludens-1 Interaction Is Critical for Calcitonin-Stimulated Prostate Cancer Metastasis

The role of neuroendocrine peptide calcitonin (CT) and its receptor (CTR) in epithelial cancer progression is an emerging concept with great clinical potential. Expression of CT and CTR is frequently elevated in prostate cancers (PCs) and activation of CT–CTR axis in non-invasive PC cells induces an invasive phenotype. Here we show by yeast-two hybrid screens that CTR associates with the tight junction protein Zonula Occludens-1 (ZO-1) via the interaction between the type 1 PDZ motif at the carboxy-terminus of CTR and the PDZ3 domain of ZO-1. Mutation of either the CTR C-PDZ-binding motif or the ZO-1-PDZ3 domain did not affect binding of CTR with its ligand or G-protein-mediated signaling but abrogated destabilizing actions of CT on tight junctions and formation of distant metastases by orthotopically implanted PC cells in nude mice, indicating that these PDZ domain interactions were pathologically relevant. Further, we observed CTR-ZO-1 interactions in PC specimens by proximity ligation immunohistochemistry, and identified that the number of interactions in metastatic PC specimens was several-fold larger than in non-metastatic PC. Our results for the first time demonstrate a mechanism by which PDZ-mediated interaction between CTR and ZO1 is required for CT-stimulated metastasis of prostate cancer. Since many receptors contain PDZ-binding motifs, this would suggest that PDZ-binding motif-adaptor protein interactions constitute a common mechanism for cancer metastasis.

Copper Transporter-CTR1 Expression and Pathological Outcomes in Platinum-treated Muscle-invasive Bladder Cancer Patients

BACKGROUND/AIM

Platinum (Pt)-based neoadjuvant chemotherapy (NAC) is the standard-of-care for muscle-invasive bladder cancer (MIBC). However, the survival benefit with NAC is driven by patients with pathological response at cystectomy. Non-responders are subject to adverse effects of Pt, with delay in definitive treatment. Copper transporter receptor 1 (CTR1) plays an important role in Pt uptake and the level of expression may influence Pt sensitivity. We hypothesized that tumor CTR1 expression correlated with pathological outcome.

PATIENTS AND METHODS

We identified matched paraffin-embedded tissues from pre-NAC transurethral bladder tumor resection (TURBT) and post-NAC radical cystectomy (RC) specimens in 47 patients with MIBC who received Pt-based NAC. Tumor and adjacent normal tissues were stained with CTR1 antibody. CTR1 expression was determined through immunohistochemistry by two pathologists blinded to the outcome (0=undetectable; 1+=barely detectable; 2+=moderate; and 3+=intense staining). Pathological response was defined as either down-staging to non-MIBC (≤pT1N0M0) or complete pathological response (pT0). Pathological outcome was compared between the CTR1 expression groups.

RESULTS

Forty-three percent of TURBT and 41% of RC specimens expressed a CTR1 score of 3+. Forty-four percent of patients had a pathological response to NAC, and 17% had pT0 disease at cystectomy. In both pre-NAC TURBT and post-NAC RC specimens, a CTR1 expression score of 3+ correlated with pathological response (p=0.0076 and p=0.023, respectively).

CONCLUSION

This is the first study to demonstrate a correlation between CTR1 tumor expression and pathological outcome in Pt-treated MIBC. These findings suggest that CTR1 expression may be a biomarker for Pt sensitivity.

Evidence for a Proapoptotic Role of Matrix Metalloproteinase-26 in Human Prostate Cancer Cells and Tissues

Matrix metalloproteinases (MMPs) play intricate roles in cancer progression; some promote invasion and angiogenesis while others suppress tumor growth. For example, human MMP-26/endometase/matrilysin-2 was reported to be either protective or pro-tumorigenic. Our previous reports suggested pro-invasion and anti-inflammation properties in prostate cancer. Here, we provide evidence for a protective role of MMP-26 in the prostate. MMP-26 expression levels in androgen-repressed human prostate cancer (ARCaP) cells, transfected with sense or anti-sense MMP-26 cDNA, are directly correlated with those of the pro-apoptotic marker Bax. Immunohistochemical staining of prostate cancer tissue samples shows similar protein expression patterns, correlating the expression levels of MMP-26 and Bax in benign, neoplastic, and invasive prostate cancer tissues. The MMP-26 protein levels were upregulated in high grade prostate intraepithelial neoplasia (HGPIN) and decreased during the course of disease progression. Further analysis using an indirect terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay showed that many tumor cells expressing MMP-26 were undergoing apoptosis. This study showed that the high level of MMP-26 expression is positively correlated with the presence of apoptotic cells. This pro-apoptotic role of MMP-26 in human prostate cancer cells and tissues may enhance our understanding of the paradoxical roles of MMP-26 in tumor invasion and progression.

Immunohistochemical distinction of metastases of renal cell carcinoma to the adrenal from primary adrenal nodules, including oncocytic tumor

Metastases of clear cell renal cell carcinoma to the adrenal can mimic primary adrenal cortical neoplasms or normal adrenal, especially in biopsy material. We compared 34 cases of clear cell renal cell carcinoma metastasis to the adrenal with 49 primary adrenal lesions (16 carcinoma, 22 adenoma, 9 oncocytic tumor, and 2 hyperplasia). Normal adrenal was available in 59 cases. Each entity was represented on tissue microarrays by duplicate-triplicate evaluable spots taken from spatially separate areas. Two pathologists evaluated all reactivity from 0 to 3+. A panel of 12 immunohistochemical stains was performed, including the first diagnostic uses of steroid receptor coactivator (SRC1) and equilibrative nucleoside transporter 1 (ENT1). The most sensitive and specific renal cell carcinoma markers were membranous reactivity for carbonic anhydrase IX (CAIX) and RCC marker and nuclear reactivity for PAX8. For adrenal cortical carcinomas, best markers were synaptophysin, SRC1, and MelanA; and for adrenal oncocytic tumor, synaptophysin and ENT1. Optimal markers for adrenal cortical adenoma and normal adrenal were ENT1 (more specific) and either MelanA or SRC1 (more sensitive). Calretinin, cytokeratin 34βE12 and CAM5.2, inhibin, and steroidogenic factor 1 (SF1) proved less valuable to the panel. Nonspecific cytoplasmic biotin reactivity was frequent for CAIX and PAX8. Tumors with high-grade cytology should be worked up with 2 of the 3 stains: CAIX, PAX8, or RCC marker; and either SRC1 or MelanA. Adrenal adenoma, or normal adrenal, versus low-grade renal cell carcinoma are distinguished by a panel of: CAIX, PAX8, or RCC Marker; ENT1 and either SRC1 or MelanA.

Reduced expression of GDF-15 is associated with atrophic inflammatory lesions of the prostate

BACKGROUND

Accumulating evidence suggests that chronic prostatic inflammation may lead to prostate cancer development. Growth differentiation factor-15 (GDF-15) is highly expressed in the prostate and has been associated with inflammation and tumorigenesis.

METHODS

To examine the relationship between GDF-15 and prostatic inflammation, GDF-15 expression was measured by immunohistochemical (IHC) staining in human prostatectomy specimens containing inflammation. The relationship between GDF-15 and specific inflammatory cells was determined using non-biased computer image analysis. To provide insight into a potential suppressive role for GDF-15 in inflammation, activation of inflammatory mediator nuclear factor of kappa B (NFκB) was measured in PC3 cells.

RESULTS

GDF-15 expression in luminal epithelial cells was decreased with increasing inflammation severity, suggesting an inverse association between GDF-15 and inflammation. Quantification of IHC staining by image analysis for GDF-15 and inflammatory cell markers revealed an inverse correlation between GDF-15 and CD3+, CD4+, CD8+, CD68+, and inos+ leukocytes. GDF-15 suppressed NFκB activity in luciferase reporter assays. Expression of the NFκB target, interleukin 8 (IL-8), was downregulated by GDF-15.

CONCLUSIONS

The inverse relationship between GDF-15 and inflammation demonstrates a novel expression pattern for GDF-15 in the human prostate and suppression of NFκB activity may shed light on a potential mechanism for this inverse correlation.

A cell of origin gene signature indicates human bladder cancer has distinct cellular progenitors

There are two distinct forms of urothelial (bladder) cancer: muscle-invasive (MI) and nonmuscle invasive (NMI) disease. Since it is currently believed that bladder cancer arises by transformation of urothelial cells of the basal layer, bladder cancer stem cells (CSCs) have been isolated based on expression markers found in such cells. However, these CSCs have only been identified in MI tumors raising the intriguing hypothesis that NMI tumor progenitors do not arise from the basal compartment. To test this hypothesis, we carried out genome-wide expression profiling of laser capture microdissected basal and umbrella cells, the two most histologically distinct cell types in normal urothelium and developed a cell of origin (COO) gene signature that distinguishes these. The COO signature was a better predictor of stage and survival than other bladder, generic, or breast CSC signatures and bladder cell differentiation markers in multiple patient cohorts. To assess whether NMI and MI tumors arise from a distinct progenitor cell (DPC) or common progenitor cell, we developed a novel statistical framework that predicts COO score as a function of known genetic alterations (TP53, HRAS, KDM6A, and FGFR3) that drive either MI or NMI bladder cancer and compared this to the observed COO score of the tumor. Analysis of 874 patients in five cohorts established the DPC model as the best fit to the available data. This observation supports distinct progenitor cells in NMI and MI tumors and provides a paradigm shift in our understanding of bladder cancer biology that has significant diagnostic and therapeutic implications.

Paneth cell-like change in benign prostate can account for P504S (AMACR) reactivity

Paneth cell-like neuroendocrine metaplasia of benign and cancerous prostate was described in 1992. Here, we note that P504S (AMACR), the cytoplasmic marker for prostate cancer used alone or in concert with basal cell markers, can be strongly reactive in benign prostatic acini with Paneth cell-like change.

Antral atrophy, intestinal metaplasia, and preneoplastic markers in Mexican children with Helicobacter pylori-positive and Helicobacter pylori-negative gastritis

Chronic inflammation and infection are major risk factors for gastric carcinogenesis in adults. As chronic gastritis is common in Mexican children, diagnosis of Helicobacter pylori and other causes of gastritis are critical for the identification of children who would benefit from closer surveillance. Antral biopsies from 82 Mexican children (mean age, 8.3 ± 4.8 years) with chronic gastritis (36 H pylori+, 46 H pylori-) were examined for gastritis activity, atrophy, intestinal metaplasia (IM), and immunohistochemical expression of gastric carcinogenesis biomarkers caudal type homeobox 2 (CDX2), ephrin type-B receptor 4 (EphB4), matrix metalloproteinase 3 (MMP3), macrophage migration inhibitory factor (MIF), p53, β-catenin, and E-cadherin. Atrophy was diagnosed in 7 (9%) of 82, and IM, in 5 (6%) of 82 by routine histology, whereas 6 additional children (7%) (3 H pylori+) exhibited aberrant CDX2 expression without IM. Significant positive correlations were seen between EphB4, MMP3, and MIF (P<.0001). Atrophy and follicular pathology were more frequent in H pylori+ biopsies (P<.0001), whereas IM and CDX2 expression showed no significant correlation with H pylori status. Antral biopsies demonstrating atrophy, IM, and/or aberrant CDX2 expression were seen in 21.95% (18/82) of the children, potentially identifying those who would benefit from closer surveillance and preventive dietary strategies. Biomarkers CDX2, EphB4, MMP3, and MIF may be useful in the workup of pediatric gastritis.

Renal epithelioid angiomyolipoma with a negative premelanosome marker immunoprofile: a case report and review of the literature

Introduction

The rare variant of renal epithelioid/pleomorphic angiomyolipoma has been reported in approximately 120 cases. One of the most important characteristics to differentiate these tumors from other renal cell neoplasms is their typical reactivity to premelanosome antigens. If such a tumor does not stain for HMB-45 or Melan-A, a specific diagnosis of epithelioid pleomorphic angiomyolipoma cannot be made with certainty.

Case presentation

We present here what is, to the best of our knowledge, the first case of epithelioid/pleomorphic angiomyolipoma of the kidney in a 50-year-old Caucasian man with no history of tuberous sclerosis, and with a tumor marker profile negative for several premelanosome antigens. The tumor was composed of sheets of pleomorphic, round to polygonal epithelioid cells with prominent eosinophilic cytoplasm, large nuclei, many multinucleated, and very prominent nucleoli. There were prominent vessels and rare interspersed smooth muscle fibers, but adipocytes were not identified. A tumor marker profile showed tumor cell reactivity for CD68, calponin and focally for CD10. Intervening smooth muscle was reactive with smooth muscle actin. The tumor lacked reactivity for melanin-associated antigens HMB-45 and Melan-A, and for CD31, pan-cytokeratin (AE1/3) and desmin. Electron microscopic examination of tumor cells confirmed the presence of premelanosome-like granules.

Conclusions

Based on the characteristic microscopic appearance of this tumor, and its overall tumor marker profile, we concluded this was a renal epithelioid/pleomorphic angiomyolipoma with a negative premelanosome antigen phenotype.

Is atypical adenomatous hyperplasia of the prostate a precursor lesion?

BACKGROUND

Alpha-methylacyl-CoA racemase (AMACR) is highly expressed in prostatic adenocarcinoma. The precursor nature of atypical adenomatous hyperplasia (AAH) is uncertain.

METHODS

One hundred twenty-one AAH foci from 101 patients who underwent transurethral prostatic resection or prostatectomy were immunohistochemically analyzed for AMACR, high molecular weight cytokeratin 34βE12, and p63 expression by a triple antibody (PIN4) cocktail stain.

RESULTS

Sixty-eight foci (56%) of AAH showed no AMACR immunostaining. Fourteen cases (12%) showed weak AMACR immunoreactivity in 1-9% of lesional cells. Sixteen cases (13%) showed strong immunopositivity for AMACR in >50% of lesional cells. AMACR expression in AAH was significantly higher in cases in which coexisting PCA was present, compared with its expression in AAH foci without coexisting PCA (P = 0.03). Strong diffuse AMACR positivity in over 50% of lesional cells was seen almost exclusively in AAH foci with coexisting PCA (P = 0.002). AMACR expression in AAH showed no correlation with patient age (P = 0.38), specimen type (P = 0.35), prostate weight (P = 0.80), zonal location (P = 0.50), distance to cancer (P = 0.28), Gleason score (P = 0.06), or pathologic stage (P = 0.23). Increased AMACR expression showed a negative correlation with the size of AAH foci (P = 0.03). All AAH lesions showed fragmented basal cell layers, highlighted by p63 and high molecular weight cytokeratin staining.

CONCLUSIONS

A significant percentage of AAH cases show stronger and more extensive AMACR expression when associated with prostatic adenocarcinoma, as compared to AAH foci found without coexisting prostate cancer. Our data provide additional evidence linking AAH to prostatic adenocarcinoma.

Current perspectives on Gleason grading of prostate cancer

The 5-tier Gleason grading system for prostate cancer, introduced in 1966, has been proven to be one of the main independent predictors of prostate cancer outcome. This review addresses interobserver concordance in Gleason grading; the persistence of grading discrepancies with frequent upgrading from the biopsy to the prostatectomy specimen; the 2005 International Society of Urologic Pathologists' modifications to Gleason grading; the impact of this modified grading on grade migration and outcome prediction; and molecular correlates of cancer morphology. Data from the most recent years are emphasized.

Papillary cystadenofibroma of epididymis: a case report

We present the first reported case of papillary cystadenofibroma of the epididymis. The tumor occurred in a 46-year-old man. The mass was 3.7 cm and included a hemorrhagic fluid-filled cyst. Microscopically, stromal-filled papillae were lined by low cuboidal to columnar epithelium. Epithelial cells were reactive for cytokeratin 7, cytokeratins AE1/3, and focally in the apical cytoplasm for CD10. Focal CD10 reactivity was also noted in the stroma. The lesion was negative for alpha-fetoprotein. These findings ruled out other lesions, including metastatic renal cell carcinoma.

Digital quantification of five high-grade prostate cancer patterns, including the cribriform pattern, and their association with adverse outcome

Proper grading of the cribriform prostate cancer pattern has not previously been supported by outcome-based evidence. Among 153 men who underwent radical prostatectomy, 76 with prostate-specific antigen (PSA) failure (≥0.2 ng/mL [0.2 μg/L]) were matched to 77 without failure. Frequencies of high-grade patterns included fused small acini, 83.7%; papillary, 52.3%; large cribriform, 37.9%; small (≤12 lumens) cribriform, 17.0%; and individual cells, 22.9%. A cribriform pattern was present in 61% (46/76) of failures but 16% (12/77) of nonfailures (P < .0001). Multivariate analysis showed the cribriform pattern had the highest odds ratio for PSA failure, 5.89 (95% confidence interval, 2.53-13.70; P < .0001). The presence of both large and small cribriform patterns was significantly linked to failure. The cumulative odds ratio of failure per added square millimeter of cribriform pattern was 1.173 (P = .008), higher than for any other pattern. All 8 men with a cribriform area sum of 25 mm(2) or more had failure (range, 33-930). Regrading cribriform cancer as Gleason 5 improved the grade association with failure, although half of all cases with individual cells also had a cribriform pattern, precluding a precise determination of the independent importance of the latter. The cribriform pattern has particularly adverse implications for outcome.

Metastasis suppressors in human benign prostate, intraepithelial neoplasia, and invasive cancer: their prospects as therapeutic agents

Despite advances in diagnosis and treatment of prostate cancer, development of metastases remains a major clinical challenge. Research efforts are dedicated to overcome this problem by understanding the molecular basis of the transition from benign cells to prostatic intraepithelial neoplasia (PIN), localized carcinoma, and metastatic cancer. Identification of proteins that inhibit dissemination of cancer cells will provide new perspectives to define novel therapeutics. Development of antimetastatic drugs that trigger or mimic the effect of metastasis suppressors represents new therapeutic approaches to improve patient survival. This review focuses on different biochemical and cellular functions of metastasis suppressors known to play a role in prostate carcinogenesis and progression. Ten putative metastasis suppressors implicated in prostate cancer are discussed. CD44s is decreased in both PIN and cancer; Drg-1, E-cadherin, KAI-1, RKIP, and SSeCKS show similar expression between benign epithelia and PIN, but are downregulated in invasive cancer; whereas, maspin, MKK4, Nm23 and PTEN are upregulated in PIN and downregulated in cancer. Moreover, the potential role of microRNA in prostate cancer progression, the understanding of the cellular distribution and localization of metastasis suppressors, their mechanism of action, their effect on prostate invasion and metastasis, and their potential use as therapeutics are addressed.

Cell adhesion molecule CD44: its functional roles in prostate cancer

CD44 is a cell adhesion glycoprotein that also governs cell signaling. Dysregulated CD44 expression characterizes most human cancers, including prostate cancer (PCa). PCa loses expression of CD44 standard (CD44s) that is present in benign epithelium, and overexpresses the novel splice variant (v) isoform, CD44v7-10. We studied CD44 in PCa for more than a decade, and in a series of papers, established its functional significance. Using retrovi-ral gene delivery to PC-3M PCa cells, we expressed luciferase-only, enforced CD44s re-expression as a fusion protein with luciferase at its C-terminus or as a protein separate from luciferase, or knocked down CD44v7-10 by RNAi. Invasion, migration, proliferation, soft agar colony formation, adhesion, Docetaxel sensitivity, and xenograft growth assays were carried out. Compared to luciferase-only PC-3M cells, all 3 treatments reduced invasion and migration. Growth and soft agar colony formation were reduced only by re-expression of CD44s as a separate or fusion protein but not CD44v7-10 RNAi. Hyaluronan and osteopontin binding were greatly strengthened by CD44s expression as a separate protein, but not a fusion protein. CD44v7-10 RNAi in PC-3M cells caused marked sensitization to Docetaxel; the 2 CD44s re-expression approaches caused minimal sensitization. In limited numbers of mouse subcutaneous xeno-grafts, all 3 alterations produced only nonsignificant trends toward slower growth compared with luciferase-only controls. In further work, we tested the effects of the anti-growth compound silibinin, a milk thistle derivative. Using a luciferase promoter construct to test for CD44 promoter activity, silibinin significantly and dose-dependently inhibited promoter activity at physiologic doses. Total CD44 RNA and CD44v7-10 RNA were significantly decreased; both were also decreased at the protein level. Phenyl-methylene hydantoins (PMH), guanidine alkaloids derived from Red Sea sponges, have the ability to increase cell-cell adhesion in prostate cancer cells and reduce invasion. Expression of CD44 total mRNA and CD44v7-10 were markedly decreased by PMH and its S-ethyl derivative. The oncogenic mi-croRNAs, miR-373 and miR-520c, which interact with CD44, were studied in prostate cancer cells and human tissues. We found that they bound the 3' untranslated region of the CD44 RNA, and suppressed CD44 in prostate cancer, by preventing the translation of CD44 RNA, rather than by degrading the RNA. Thus, stable re-expression of CD44s reduces PCa growth and invasion in vitro, and possibly in vivo, suggesting CD44's potential as gene therapy. Finally, CD44v7-10 may be a target for chemosensitization, and plays a role in nutraceutical abrogation of tumor development. In vivo effects of CD44 alteration still need to be investigated by use of orthotopic or renal capsule xenografts, which confer a different stromal microenvironment than that of the subcutaneous grafts.

Dutasteride prevents the growth response to testosterone in benign and androgen-sensitive malignant prostate cells

We show that the dual 5-α reductase enzyme inhibitor dutasteride prevents enhanced growth of both benign and malignant prostate cell lines, incubated with physiologic to supraphysiologic doses of testosterone. Using androgen-sensitive benign BPH-1 cells, LNCaP cancer cells, their derivative C4-2 cells, or Dunning rat cancer cells, we subjected 30,000 cells/well to concomitant treatment with 10(-9), 10(-8), or 10(-7) M testosterone in the presence of low (0.25 μM) or high (1.0 μM) doses of dutasteride. Both low- and high-dose dutasteride abrogated testosterone-stimulated growth of all 4 cell lines. If the in vitro data mimic conditions in men undergoing testosterone replacement, concomitant dutasteride use might make testosterone safe for men with benign prostatic hypertrophy, latent prostate cancer and perhaps even aggressive prostate cancer. Testosterone might also be used to prevent the rare anti-androgen side effects of dutasteride when used for benign prostatic hypertrophy and baldness. Further clinical investigation is indicated.

Protein profiling of isolated leukocytes, myofibroblasts, epithelial, Basal, and endothelial cells from normal, hyperplastic, cancerous, and inflammatory human prostate tissues

In situ neoplastic prostate cells are not lethal unless they become invasive and metastatic. For cells to become invasive, the prostate gland must undergo degradation of the basement membrane and disruption of the basal cell layer underneath the luminal epithelia. Although the roles of proteinases in breaking down the basement membrane have been well-studied, little is known about the factors that induce basal cell layer disruption, degeneration, and its eventual disappearance in invasive cancer. It is hypothesized that microenvironmental factors may affect the degradation of the basal cell layer, which if protected may prevent tumor progression and invasion. In this study, we have revealed differential protein expression patterns between epithelial and stromal cells isolated from different prostate pathologies and identified several important epithelial and stromal proteins that may contribute to inflammation and malignant transformation of human benign prostate tissues to cancerous tissues using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and proteomics methods. Cellular retinoic acid-binding protein 2 was downregulated in basal cells of benign prostate. Caspase-1 and interleukin-18 receptor 1 were highly expressed in leukocytes of prostate cancer. Proto-oncogene Wnt-3 was downregulated in endothelial cells of prostatitis tissue and tyrosine phosphatase non receptor type 1 was only found in normal and benign endothelial cells. Poly ADP-ribose polymerase 14 was downregulated in myofibroblasts of prostatitis tissue. Interestingly, integrin alpha-6 was upregulated in epithelial cells but not detected in myofibroblasts of prostate cancer. Further validation of these proteins may generate new strategies for the prevention of basal cell layer disruption and subsequent cancer invasion.

Abstract 551: Protein biomarkers of human prostate cancer stromal cells

In situ human prostate tumors are not lethal unless they become invasive and metastatic. For cells to become invasive, the prostate gland must undergo disruption of the basal cell layer and degradation of the basement membrane underneath the luminal epithelial cell layer. Although the roles of proteinases in breaking down the basement membrane have been well-studied, little is known about the factors that induce basal cell layer disruption, degeneration, and its eventual disappearance in invasive cancer. It is hypothesized that microenvironmental factors may affect the degradation of the basal cell layer which if protected may prevent tumor progression and invasion. In this study, we have revealed differential protein expression patterns between cells separated from different prostate pathologies and identified several important stromal proteins that may contribute to inflammation and malignant transformation of benign prostate tissues to cancerous tissues using mass spectrometry and proteomics methods. The identifications of these proteins may generate new strategies for the prevention of basal cell layer disruption leading to the eventual blockade of invasive prostate carcinomas. Furthermore, human matrix metalloproteinase-26/endometase/matrilysin-2 was also investigated and its expression in preinvasive human prostate cancer cells may be associated with the expression of some apoptotic markers. This work may contribute to our understanding of epithelial-stromal interaction in the progression of human prostate cancer. (This work was supported in part by grants DAMD17-02-1-0238 and W81XWH-07-1-0225 from DOD, US Congressionally Directed Medical Research Programs, a grant from the Elsa U. Pardee Foundation, and grants from Florida State University to Dr. Q.-X. Sang)

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 551.

Characterization of prostate cancer in needle biopsy by cathepsin B, cell proliferation and DNA ploidy

BACKGROUND

Our objective was to determine localization patterns of three distinct groups of biomarkers (cathepsin B, MIB-1 and DNA ploidy) in prostate needle biopsy sections to establish localization similarities (or differences) in biopsy and retropubic prostatectomy specimens (RPs).

MATERIALS AND METHODS

Prostate needle biopsy specimens and matched RPs from 47 patients with cancer were evaluated. Biopsy and RP sections were stained with anti-cathepsin B (CB) and anti-stefin (cystatin) A (SA) and for cell proliferation and DNA ploidy. The ratio of CB to SA in stained cells was calculated for each biopsy cancer and matched benign prostatic hyperplasia (BPH) sample.

RESULTS

The geometric mean of CB to SA was 1.45 in BPH and 2.99 in cancer specimens (p=0.0001). The percentage of S-phase cells and DNA ploidy status in needle biopsy was associated with cancer volume in RP cases (p=0.03).

CONCLUSION

Our study has indicated that the ratio of CB to SA is significantly higher in prostate cancer biopsy specimens than in BPH. The percentage of S-phase cells and DNA ploidy in needle biopsies predicts cancer volume of RPs. We have shown that localization of three distinct biomarkers in biopsies reliably assesses the nature of prostate cancer in biopsy sections.

Stable alterations of CD44 isoform expression in prostate cancer cells decrease invasion and growth and alter ligand binding and chemosensitivity

Background

Dysregulated CD44 expression characterizes most human cancers, including prostate cancer (PCa). PCa loses expression of CD44 standard (CD44s) that is present in benign epithelium, and overexpresses the novel splice variant isoform, CD44v7-10.

Methods

Using retroviral gene delivery to PC-3M PCa cells, we expressed luciferase-only, enforced CD44s re-expression as a fusion protein with luciferase at its C-terminus or as a protein separate from luciferase, or knocked down CD44v7-10 by RNAi. Invasion, migration, proliferation, soft agar colony formation, adhesion, Docetaxel sensitivity, and xenograft growth assays were carried out. Expression responses of merlin, a CD44 binding partner, and growth-permissive phospho-merlin, were assessed by western blot.

Results

Compared to luciferase-only PC-3M cells, all three treatments reduced invasion and migration. Growth and soft agar colony formation were reduced only by re-expression of CD44s as a separate or fusion protein but not CD44v7-10 RNAi. Hyaluronan and osteopontin binding were greatly strengthened by CD44s expression as a separate protein, but not a fusion protein. CD44v7-10 RNAi in PC-3M cells caused marked sensitization to Docetaxel; the two CD44s re-expression approaches caused minimal sensitization. In limited numbers of mouse subcutaneous xenografts, all three alterations produced only nonsignificant trends toward slower growth compared with luciferase-only controls. The expression of CD44s as a separate protein, but not a fusion protein, caused emergence of a strongly-expressed, hypophosphorylated species of phospho-merlin.

Conclusion

Stable re-expression of CD44s reduces PCa growth and invasion in vitro, and possibly in vivo, suggesting CD44 alterations have potential as gene therapy. When the C-terminus of CD44s is fused to another protein, most phenotypic effects are lessened, particularly hyaluronan adhesion. Finally, CD44v7-10, although it was not functionally significant for growth, may be a target for chemosensitization.

Phenyl-methylene hydantoins alter CD44-specific ligand binding of benign and malignant prostate cells and suppress CD44 isoform expression

Dysregulated CD44 expression is a feature of most human cancers, including prostate cancer (PCa). PCa loses expression of CD44 standard (CD44s) which is present in benign epithelium, and overexpresses a novel splice variant isoform, CD44v7-10, specifically facilitating fibronectin binding and invasion. Naturally-occurring or synthetic phenyl-methylene hydantoin (PMH) and S-ethyl PMH (S-PMH) can reportedly augment cell-cell adhesion, and reduce invasion and growth of PCa. Benign BPH-1 and malignant PC-3M prostate cells were treated with PMH or S-PMH for 36 h and cells were harvested. Cell adhesion assays were carried out. Cancer cells' expression of total CD44 and CD44v7-10 were tested by western blot analysis and real-time RT-PCR. Compared to BPH-1 or PC-3M cells treated with vehicle only, PMH-or S-PMH-treated benign and malignant cells had decreased adhesion to hyaluronan (p=0.001 to 0.007) and fibronectin (p<0.001 to 0.047). Both compounds decreased PCa expression of CD44 total mRNA (representing mostly CD44s, to 0.076+/-0.033 and 0.254+/-0.123 of control) and CD44v7-10 (to 0.386+/-0.279 and 0.115+/-0.037 of control). S-PMH but not PMH decreased CD44 total protein, while both decreased CD44v7-10 protein. Both hydantoins lowered beta-catenin, as reported previously. Both only slightly decreased beta1-integrin, the definitive receptor for fibronectin. In conclusion, the ability of PMH and S-PMH to decrease hyaluronan adhesion appears to be mediated through decreased CD44s, while the decrease in fibronectin adhesion correlates with, and may be mediated by, decreased CD44v7-10.