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Li J, Huang Z, Wang P, Li R, Gao L, Lai KP. Therapeutic targets of formononetin for treating prostate cancer at the single-cell level. Aging (Albany NY) 2024; 16:10380-10401. [PMID: 38874510 PMCID: PMC11236323 DOI: 10.18632/aging.205935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/22/2024] [Indexed: 06/15/2024]
Abstract
Prostate cancer is one of the serious health problems of older male, about 13% of male was affected by prostate cancer. Prostate cancer is highly heterogeneity disease with complex molecular and genetic alterations. So, targeting the gene candidates in prostate cancer in single-cell level can be a promising approach for treating prostate cancer. In the present study, we analyzed the single cell sequencing data obtained from 2 previous reports to determine the differential gene expression of prostate cancer in single-cell level. By using the network pharmacology analysis, we identified the therapeutic targets of formononetin in immune cells and tissue cells of prostate cancer. We then applied molecular docking to determine the possible direct binding of formononetin to its target proteins. Our result identified a cluster of differential gene expression in prostate cancer which can serve as novel biomarkers such as immunoglobulin kappa C for prostate cancer prognosis. The result of network pharmacology delineated the roles of formononetin's targets such CD74 and THBS1 in immune cells' function of prostate cancer. Also, formononetin targeted insulin receptor and zinc-alpha-2-glycoprotein which play important roles in metabolisms of tissue cells of prostate cancer. The result of molecular docking suggested the direct binding of formononetin to its target proteins including INSR, TNF, and CXCR4. Finally, we validated our findings by using formononetin-treated human prostate cancer cell DU145. For the first time, our result suggested the use of formononetin for treating prostate cancer through targeting different cell types in a single-cell level.
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Affiliation(s)
- Jiawei Li
- Department of Urology Surgery, The Second Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, PR China
| | | | - Ping Wang
- Key Laboratory of Environmental Pollution and Integrative Omics, Guilin Medical University, Education Department of Guangxi Zhuang Autonomous Region, Guilin Medical University, Guilin, PR China
| | - Rong Li
- Key Laboratory of Environmental Pollution and Integrative Omics, Guilin Medical University, Education Department of Guangxi Zhuang Autonomous Region, Guilin Medical University, Guilin, PR China
| | - Li Gao
- Department of Urology Surgery, The Second Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, PR China
| | - Keng Po Lai
- Key Laboratory of Environmental Pollution and Integrative Omics, Guilin Medical University, Education Department of Guangxi Zhuang Autonomous Region, Guilin Medical University, Guilin, PR China
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Ávila-Fernández P, Etayo-Escanilla M, Sánchez-Porras D, Blanco-Elices C, Campos F, Carriel V, García-García ÓD, Chato-Astrain J. A Novel In Vitro Pathological Model for Studying Neural Invasion in Non-Melanoma Skin Cancer. Gels 2024; 10:252. [PMID: 38667671 PMCID: PMC11049316 DOI: 10.3390/gels10040252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Neural Invasion (NI) is a key pathological feature of cancer in the colonization of distant tissues, and its underlying biological mechanisms are still scarcely known. The complex interactions between nerve and tumor cells, along with the stroma, make it difficult to reproduce this pathology in effective study models, which in turn has limited the understanding of NI pathogenesis. In this study, we have designed a three-dimensional model of NI squamous cell carcinoma combining human epidermoid carcinoma cells (hECCs) with a complete peripheral nerve segment encapsulated in a fibrine-agarose hydrogel. We recreated two vital processes of NI: a pre-invasive NI model in which hECCs were seeded on the top of the nerve-enriched stroma, and an invasive NI model in which cancer cells were immersed with the nerve in the hydrogel. Histological, histochemical and immunohistochemical analyses were performed to validate the model. Results showed that the integration of fibrin-agarose advanced hydrogel with a complete nerve structure and hECCs successfully generated an environment in which tumor cells and nerve components coexisted. Moreover, this model correctly preserved components of the neural extracellular matrix as well as allowing the proliferation and migration of cells embedded in hydrogel. All these results suggest the suitability of the model for the study of the mechanisms underlaying NI.
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Affiliation(s)
- Paula Ávila-Fernández
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
- Doctoral Program in Biomedicine, University of Granada, 18071 Granada, Spain
| | - Miguel Etayo-Escanilla
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - David Sánchez-Porras
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Cristina Blanco-Elices
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Óscar Darío García-García
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
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Yamada Y, Fujii Y, Kakutani S, Kimura N, Sugimoto K, Hakozaki Y, Sugihara T, Takeshima Y, Kawai T, Nakamura M, Kamei J, Taguchi S, Akiyama Y, Sato Y, Yamada D, Urabe F, Miyazaki H, Enomoto Y, Fukuhara H, Nakagawa T, Fujimura T, Kume H. Development of risk-score model in patients with negative surgical margin after robot-assisted radical prostatectomy. Sci Rep 2024; 14:7607. [PMID: 38556562 PMCID: PMC10982299 DOI: 10.1038/s41598-024-58279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/27/2024] [Indexed: 04/02/2024] Open
Abstract
A total of 739 patients underwent RARP as initial treatment for PCa from November 2011 to October 2018. Data on BCR status, clinical and pathological parameters were collected from the clinical records. After excluding cases with neoadjuvant and/or adjuvant therapies, presence of lymph node or distant metastasis, and positive SM, a total of 537 cases were eligible for the final analysis. The median follow-up of experimental cohort was 28.0 (interquartile: 18.0-43.0) months. We identified the presence of International Society of Urological Pathology grade group (ISUP-GG) ≥ 4 (Hazard ratio (HR) 3.20, 95% Confidence Interval (95% CI) 1.70-6.03, P < 0.001), lymphovascular invasion (HR 2.03, 95% CI 1.00-4.12, P = 0.049), perineural invasion (HR 10.7, 95% CI 1.45-79.9, P = 0.020), and maximum tumor diameter (MTD) > 20 mm (HR 1.9, 95% CI 1.01-3.70, P = 0.047) as significant factors of BCR in the multivariate analysis. We further developed a risk model according to these factors. Based on this model, 1-year, 3-year, and 5-year BCR-free survival were 100%, 98.9%, 98.9% in the low-risk group; 99.1%, 94.1%, 86.5% in the intermediate-risk group; 93.9%, 84.6%, 58.1% in the high-risk group. Internal validation using the bootstrap method showed a c-index of 0.742 and an optimism-corrected c-index level of 0.731. External validation was also carried out using an integrated database derived from 3 other independent institutions including a total of 387 patients for the final analysis. External validation showed a c-index of 0.655. In conclusion, we identified risk factors of biochemical failure in patients showing negative surgical margin after RARP and further developed a risk model using these risk factors.
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Affiliation(s)
- Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Yoichi Fujii
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shigenori Kakutani
- Department of Urology, Chiba Tokushukai Hospital, Funabashi-Shi, Chiba, Japan
| | - Naoki Kimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Kazuma Sugimoto
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Yuji Hakozaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Toru Sugihara
- Department of Urology, Jichi Medical University, Shimotsuke-Shi, Tochigi-Ken, Japan
| | - Yuta Takeshima
- Division of Innovative Cancer Therapy, Advanced Research Center, The Institute of Medical Science, The University of Tokyo, Minato-Ku, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Masaki Nakamura
- Department of Urology, NTT Medical Center Tokyo, Shinagawa-Ku, Tokyo, Japan
| | - Jun Kamei
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideyo Miyazaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Urology, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Yutaka Enomoto
- Department of Urology, Mitsui Memorial Hospital, Chiyoda-Ku, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Jichi Medical University, Shimotsuke-Shi, Tochigi-Ken, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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Li YT, Yuan WZ, Jin WL. Vagus innervation in the gastrointestinal tumor: Current understanding and challenges. Biochim Biophys Acta Rev Cancer 2023; 1878:188884. [PMID: 36990250 DOI: 10.1016/j.bbcan.2023.188884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023]
Abstract
The vagus nerve (VN) is the main parasympathetic nerve of the autonomic nervous system. It is widely distributed in the gastrointestinal tract and maintains gastrointestinal homeostasis with the sympathetic nerve under physiological conditions. The VN communicates with various components of the tumor microenvironment to positively and dynamically affect the progression of gastrointestinal tumors (GITs). The intervention in vagus innervation delays GIT progression. Developments in adeno-associated virus vectors, nanotechnology, and in vivo neurobiological techniques have enabled the creation of precisely regulated "tumor neurotherapies". Furthermore, the combination of neurobiological techniques and single cell sequencing may reveal more insights into VN and GIT. The present review aimed to summarize the mechanisms of communication between the VN and the gastrointestinal TME and to explore the potential and challenges of VN-based tumor neurotherapy in GITs.
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Zhang B, Wang S, Fu Z, Gao Q, Yang L, Lei Z, Shi Y, Le K, Xiong J, Liu S, Zhang J, Su J, Chen J, Liu M, Niu B. Single-cell RNA sequencing reveals intratumoral heterogeneity and potential mechanisms of malignant progression in prostate cancer with perineural invasion. Front Genet 2023; 13:1073232. [PMID: 36712886 PMCID: PMC9875799 DOI: 10.3389/fgene.2022.1073232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Prostate cancer (PCa) is the second most common cancer among men worldwide. Perineural invasion (PNI) was a prominent characteristic of PCa, which was recognized as a key factor in promoting PCa progression. As a complex and heterogeneous disease, its true condition is difficult to explain thoroughly with conventional bulk RNA sequencing. Thus, an improved understanding of PNI-PCa progression at the single-cell level is needed. Methods: In this study, we performed scRNAseq on tumor tissues of three PNI-PCa patients. Principal component analysis (PCA) and Uniform manifold approximation and projection (UMAP) were used to reduce dimensionality and visualize the cellular composition of tumor tissues. The differently expressed genes among each cluster were identified by EdgeR. GO enrichment analysis was used to understand the roles of genes within the clusters. Pseudotime cell trajectory was used to reveal the molecular pathways underlying cell fate decisions and identify genes whose expression changed as the cells underwent transition. We applied CellPhoneDB to identify cell-cell interactions among the epithelial and neural cells in PNI-PCa. Results: Analysis of the ∼17,000 single-cell transcriptomes in three PNI prostate cancer tissues, we identified 12 major cell clusters, including neural cells and two epithelial subtypes with different expression profiles. We found that basal/intermediate epithelial cell subtypes highly expressed PCa progression-related genes, including PIGR, MMP7, and AGR2. Pseudotime trajectory analysis showed that luminal epithelial cells could be the initiating cells and transition to based/intermediate cells. Gene ontology (GO) enrichment analysis showed that pathways related to cancer progressions, such as lipid catabolic and fatty acid metabolic processes, were significantly enriched in basal/intermediate cells. Our analysis also suggested that basal/intermediate cells communicate closely with neural cells played a potential role in PNI-PCa progression. Conclusion: These results provide our understanding of PNI-PCa cellular heterogeneity and characterize the potential role of basal/intermediate cells in the PNI-PCa progression.
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Affiliation(s)
- Bao Zhang
- Department of Urology, Aerospace Center Hospital, Beijing, China,*Correspondence: Bao Zhang, ; Beifang Niu,
| | - Shenghan Wang
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Zhichao Fu
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China
| | - Qiang Gao
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Lin Yang
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Zhentao Lei
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Yuqiang Shi
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Kai Le
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Jie Xiong
- Department of Urology, Aerospace Center Hospital, Beijing, China
| | - Siyao Liu
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China
| | - Jiali Zhang
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China
| | - Junyan Su
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China
| | - Jing Chen
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China
| | - Mengyuan Liu
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China,Computer Network Information Center, Chinese Academy of Sciences, Beijing, China
| | - Beifang Niu
- ChosenMed Technology (Beijing) Co., Ltd., Beijing, China,Computer Network Information Center, Chinese Academy of Sciences, Beijing, China,University of the Chinese Academy of Sciences, Beijing, China,*Correspondence: Bao Zhang, ; Beifang Niu,
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Perineural invasion as predictor of biochemical recurrence in prostate cancer following open radical prostatectomy: a single-center experience. World J Urol 2022; 40:2695-2700. [DOI: 10.1007/s00345-022-04158-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022] Open
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The Role of Perineural Invasion in Prostate Cancer and Its Prognostic Significance. Cancers (Basel) 2022; 14:cancers14174065. [PMID: 36077602 PMCID: PMC9454778 DOI: 10.3390/cancers14174065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Prostate cancer is one of the most frequently diagnosed cancers in men worldwide. Perineural invasion (PNI), the movement of cancer cells along nerves, is a commonly observed approach to tumor spread and is important in both research and clinical practice of prostate cancer. However, despite many studies reporting on molecules and pathways involved in PNI, understanding its clinical relevance remains insufficient. In this review, we aim to summarize the current knowledge of mechanisms and prognostic significance of PNI in prostate cancer, which may provide new perspectives for future studies and improved treatment. Abstract Perineural invasion (PNI) is a common indication of tumor metastasis that can be detected in multiple malignancies, including prostate cancer. In the development of PNI, tumor cells closely interact with the nerve components in the tumor microenvironment and create the perineural niche, which provides a supportive surrounding for their survival and invasion and benefits the nerve cells. Various transcription factors, cytokines, chemokines, and their related signaling pathways have been reported to be important in the progress of PNI. Nevertheless, the current understanding of the molecular mechanism of PNI is still very limited. Clinically, PNI is commonly associated with adverse clinicopathological parameters and poor outcomes for prostate cancer patients. However, whether PNI could act as an independent prognostic predictor remains controversial among studies due to inconsistent research aim and endpoint, sample type, statistical methods, and, most importantly, the definition and inclusion criteria. In this review, we provide a summary and comparison of the prognostic significance of PNI in prostate cancer based on existing literature and propose that a more standardized description of PNI would be helpful for a better understanding of its clinical relevance.
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Wang F, Liu F, Liang J, Yang F, Xing N. Preoperative Platelet Count Correlates With Postoperative Perineural Invasion on Specimen in Patients Treated With Radical Prostatectomy. Front Oncol 2022; 12:906936. [PMID: 35747816 PMCID: PMC9209647 DOI: 10.3389/fonc.2022.906936] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/13/2022] [Indexed: 12/17/2022] Open
Abstract
Objective It has been reported that perineural invasion (PNI) after radical prostatectomy (RP) is associated with unfavorable prostate cancer (PCa) prognosis. However, the clinicopathological factors especially hematological parameters that influenced PNI remain unknown. Our aim was to explore the relationship between clinicopathological parameters and PNI in patients who underwent RP. Methods A total of 348 patients with PCa who underwent RP at our center between 2018 and 2021 were consecutively collected. We divided them into non-PNI and PNI groups based on PNI status and compared clinicopathological characteristics including hematological parameters between non-PNI and PNI groups. The association of clinicopathological parameters including whole blood parameters, age, body mass index (BMI), hypertension, diabetes mellitus, prostate-specific antigen (PSA), ISUP (International Society of Urological Pathology) grade, pathological stage T (pT), and neoadjuvant hormonal therapy (NHT) with PNI was determined by univariate and multivariate logistic regression analyses. Results The pathological results of the RP specimen consisted of 254 (73.0%) patients with PNI and 94 (27.0%) cases without PNI. The level of PSA, percentages of advanced pT and grade, positive surgical margin rate, and vessel carcinoma embolus rate were significantly higher in the PNI group when compared with non-PNI counterpart (p = 0.007, p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively). Among the whole blood parameters, only platelet count and plateletcrit were significantly different [216 (178.8–252.0) vs. 200.5 (173.5–236.5), p = 0.04; 0.0021 (0.0018–0.0025) vs. 0.0020 (0.0017–0.0023), p = 0.008, respectively]. Univariate logistic regression analysis demonstrated that platelet, ISUP, and pT were all positively correlated with the presence of PNI (T3 vs. T1, odds ratio (OR) = 2.029, p = 0.020; OR = 1.697, p < 0.001; OR = 3.836, p < 0.001). In the stepwise multivariate regression analysis, the association between platelet and PNI remained significant (T2 vs. T1, OR = 2.171, 95% CI: 1.082–4.354, p = 0.029; T3 vs. T1, OR = 2.595, 95% CI: 1.259–5.349, p = 0.010) after adjusting for confounding factors including age, BMI, hypertension, diabetes mellitus, PSA, ISUP, pT, and NHT. Conclusions The study first revealed that platelet count rather than other whole blood parameters was independently associated with the presence of PNI in patients with PCa, suggesting that platelets might play an essential role in PCa aggressiveness.
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Affiliation(s)
- Fangming Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Liu
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Liang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feiya Yang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nianzeng Xing
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
- *Correspondence: Nianzeng Xing,
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Li H, Chang X, Du Y. Perineural invasion detected in prostate biopsy is a predictor of positive surgical margin of radical prostatectomy specimen: A meta-analysis. Andrologia 2022; 54:e14395. [PMID: 35233813 DOI: 10.1111/and.14395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 11/27/2022] Open
Abstract
The role of perineural invasion detected by puncture biopsy of prostate cancer remains controversial. We performed a meta-analysis to assess the relationship between positive perineural invasion at prostate biopsy and positive surgical margins (PSM) after radical prostatectomy. We searched a number of relevant electronic databases including Web of Science, Medline, PubMed, Embase, and the Cochrane Library until 31 March 2021. STATA 15.1 software was used to analyse all data for this article. The quality of these studies was assessed by the Newcastle-Ottawa Scale (ranged from 0 to 9 stars). Finally, we selected 13 high-quality studies in our meta-analysis, which contain 8283 patients. Overall pooled analysis proposed that biopsy perineural invasion was related to a higher risk of the positive surgical margins after radical prostatectomy in prostate cancer (RR: 1.73; 95% CI: 1.56-1.92; z = 10.30, p = 0.000). Moreover, the outcomes of the publication bias checkout testified that without significant bias arose (Egger's test: 0.086 > 0.05; Begg's test: 0.59 > 0.05). The existing evidence indicates that higher incidence of positive surgical margins in patients who had perineural invasion was detected in prostate biopsy.
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Affiliation(s)
- Hui Li
- Department of Urology, Fuyang People's Hospital, Fuyang, China
| | - Xuefeng Chang
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Yongqiang Du
- Fuyang People's Hospital, Anhui Medical University, Fuyang, China
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CD74 promotes perineural invasion of cancer cells and mediates neuroplasticity via the AKT/EGR-1/GDNF axis in pancreatic ductal adenocarcinoma. Cancer Lett 2021; 508:47-58. [PMID: 33766751 DOI: 10.1016/j.canlet.2021.03.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 01/06/2023]
Abstract
Perineural invasion (PNI) is a common feature of pancreatic ductal adenocarcinoma (PDAC) and is one of the important causes of local recurrence in resected pancreatic cancer, but the molecular mechanism remains largely unexplored. Here, we used immunohistochemistry staining to determine the expression of CD74. Then the in vivo PNI model, in vitro neuroplasticity assay, cell proliferation assay, wound healing and Transwell-based invasion assay were performed to examine the function of CD74 in pancreatic cancer cell lines. ChIP assay and Luciferase reporter assay were used to illustrate the mechanism underlying CD74 induced GDNF expression. We confirmed that the expression level of CD74 was an independent predictor of PNI and poor prognosis for PDAC. Moreover, we found that upregulation of CD74 on PDAC enhanced its migration and invasive capabilities and potentiated the secretion of neurotrophic factor GDNF to promote the neuroplasticity. Mechanistically, CD74 promoted GDNF production via the AKT/EGR-1/GDNF axis in PDAC. Taken together, our findings suggest a supportive role of CD74 in the PNI of PDAC, and deepen our understanding of how cancer cells promote neuroplasticity in the microenvironment of PDAC.
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11
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Lin SX, Zheng Y, Wu S, Blute ML, Dahl DM, Wu CL. Impact of biopsy perineural invasion on younger prostate cancer patients after radical prostatectomy. Scand J Urol 2020; 54:475-480. [PMID: 32930036 DOI: 10.1080/21681805.2020.1817143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To identify the potential indicators for higher-risk disease and poor outcome in younger prostate cancer (PCa) patients (age ≤ 50) who had undergone radical prostatectomy (RP) in the prostate-specific antigen (PSA) era. MATERIALS AND METHODS A total of 186 PCa cases of age ≤ 50 who underwent RP between 2003 and 2010 at our center were included for study. High-risk disease after RP was defined as cases with pre-PSA ≥ 20 ng/ml and/or Gleason score (GS) ≥ 4 + 3 and/or pT stage ≥ 3. The poor outcome group was defined as cases with biochemical recurrence (BCR) and/or metastasis (Mets) and/or all-cause death. Multivariate logistic regression models were performed to identify independent risk factors for both high-risk disease and poor outcome. RESULTS Among 186 younger PCa patients aged ≤ 50, 36 cases (19.5%) had high-risk disease and 24 cases (12.9%) had poor outcome. The presence of biopsy perineural invasion (BxPNI) was significantly associated with high-risk disease and showed a trend to correlate with worse outcome in univariate analysis. On multivariate logistic regression analysis, BxPNI was shown to be a significant independent risk factor with covariate of D'Amico for poor outcome (p = 0.047) and an independent risk factor with covariate of BxGPC for high-risk PCa excepting the variables to define high-risk disease (p = 0.013). Prognostically, cases with BxPNI showed a poor BCR-free survival in univariate analysis but did not reach significance (p = 0.063). CONCLUSION Our results show that BxPNI could be considered as a risk classification factor to identify the best candidates among younger PCa patients for further treatment and may also be used for developing active surveillance (AS) selection criteria for younger PCa patients.
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Affiliation(s)
- Sharron X Lin
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yu Zheng
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shulin Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael L Blute
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Douglas M Dahl
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Chin-Lee Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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12
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Wu S, Xie L, Lin SX, Wirth GJ, Lu M, Zhang Y, Blute ML, Dahl DM, Wu CL. Quantification of perineural invasion focus after radical prostatectomy could improve predictive power of recurrence. Hum Pathol 2020; 104:96-104. [PMID: 32673683 DOI: 10.1016/j.humpath.2020.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 01/04/2023]
Abstract
Perineural invasion (PNI) after radical prostatectomy (RP) is a common feature of prostate cancer (PCa) and has been associated with unfavorable tumor characteristics. However, its prognostic relevance is controversial. In this study, we evaluated the impact of both PNI status (PNI+ versus PNI-) and quantified number of PNI focus on the long-term prognosis of biochemical recurrence (BCR) after RP. After reevaluating PNI of a total of 721 patients with localized PCa who underwent RP at our institution between 2000 and 2002, we examined associations between PNI status or PNI focus number and clinicopathological factors including tumor stage, Gleason score, margin status, tumor location, preoperative prostate specific antigen, age, prostate weight as well as BCR outcome. PNI was present in 530 of 721 cases (73.5%) of the RP specimens and was associated with more aggressive disease. BCR occurred in 19.4% of all patients within a median follow-up period of 8.5 years. PNI+ status was associated with poor BCR prognosis in univariate analysis but lost in multivariate analysis. Based on the number of PNI focus, PNI was further divided into 2 distinct group: PNI+ a (≤3) and PNI+ b (>3). In a multivariate Cox regression model, PNI+ b (>3) was identified as an independent BCR prognostic factor. Quantification of PNI focus number beside the dichotomized status recording will not only provide more detailed information but also be a novel prognostic indicator for risk stratification. Further external validation will be needed for an optimal cut-off value of the PNI focus number. Our findings will help further research on the relevance of PNI in the pretreatment setting and support ongoing efforts to understand its role of cancer progression.
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Affiliation(s)
- Shulin Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Ling Xie
- Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Sharron X Lin
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Gregory J Wirth
- Division of Urology, Department of Surgery, Geneva University Hospital, Geneva, 1205, Switzerland
| | - Min Lu
- Department of Pathology, Peking University Third Hospital, Peking University Health Science Center, Beijing, 100191, China
| | - Yifen Zhang
- Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Michael L Blute
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Douglas M Dahl
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
| | - Chin-Lee Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
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13
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Wu S, Lin X, Lin SX, Lu M, Deng T, Wang Z, Olumi AF, Dahl DM, Wang D, Blute ML, Wu CL. Impact of biopsy perineural invasion on the outcomes of patients who underwent radical prostatectomy: a systematic review and meta-analysis. Scand J Urol 2019; 53:287-294. [PMID: 31401922 DOI: 10.1080/21681805.2019.1643913] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives: To investigate the association between biopsy perineural invasion (PNI) and oncological outcomes of prostate cancer (PCa) after radical prostatectomy (RP).Materials and methods: A systematic literature search was performed using PubMed, EMBASE and Web of Science up to December 2018 to identify the eligible studies that included localized PCa patients who underwent biopsy and subsequently RP as well as follow-up information. Meta-analyses were conducted using available hazard ratios (HRs) of biopsy PNI from both univariate and multivariate analyses.Results: Eighteen studies including 14,855 patients with treatment follow-up information were included in the current systematic review. The rate of biopsy PNI varied between 7.0% and 33.0%. Seven out of the 18 studies that demonstrated biopsy PNI were associated with adverse pathologic features. Thirteen out of the 18 studies showed biopsy PNI correlated significantly with higher rates of biochemical recurrence (BCR)/cancer progression status or worse prognostic outcomes. With pooled data based on four studies with available univariate analysis results and four studies with multivariate analysis, statistically significant associations were found between biopsy PNI and BCR with univariate analysis (HR = 2.05; 95% CI = 1.57-2.68; p < 0.001) and with multivariate analysis (HR = 1.57; 95% CI = 1.28-1.93; p < 0.001).Conclusion: Evidence from the included observational studies indicated that biopsy PNI was not only correlated with adverse pathologic characteristics but also with worse BCR prognosis of local PCa after RP. The status of biopsy PNI could serve as a promising risk-stratification factor to help the decision-making process, considering active surveillance (AS) or further treatment for PCa patients.
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Affiliation(s)
- Shulin Wu
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Xueming Lin
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Sharron X Lin
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Min Lu
- Department of Pathology, Peking University Third Hospital, Peking University Health Science Center, Beijing, China
| | - Tuo Deng
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Zongwei Wang
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Aria F Olumi
- Division of Urologic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Douglas M Dahl
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Dongwen Wang
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Michael L Blute
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Chin-Lee Wu
- Department of Urology and Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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14
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Ghinea N, Robin B, Pichon C, Leclere R, Nicolas A, Chnecker C, Côté JF, Guillonneau B, Radu A. Vasa nervorum angiogenesis in prostate cancer with perineural invasion. Prostate 2019; 79:640-646. [PMID: 30663097 DOI: 10.1002/pros.23771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/31/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Perineural invasion (PNI) is generally accepted as a major route of cancer dissemination in malignancies associated with highly enervated organs. However, the effect of cancer cells on vasa nervorum remains unknown. We studied this effect in locally advanced prostate cancer, a high-risk feature associated with approximately 20% of prostate cancer specific mortality. METHODS We used immunohistochemistry for CD34, fibroblast growth factor-2 (FGF-2), FSHR, podoplanin, vascular endothelial growth factor (VEGF), and VEGFR-2 as well as histochemical methods to examine the vasa nervorum of nerves invaded by cancer cells in tissue samples from 85 patients. RESULTS The percentage of the nerve area occupied by CD34-positive vasa nervorum endothelial cells in nerves with PNI was much higher than in nerves without PNI (7.3 ± 1.2 vs 1.9 ± 0.4; P < 0.001 and 5.8 ± 0.6 vs 1.23 ± 0.8; P < 0.001 in pT3a and pT3b prostate cancer specimens, respectively). In 19/85 of the patients the CD34-positive vasa nervorum microvessels have a thick basement membrane, similar to the vessels in diabetic microangiopathy. This subendothelial layer contains collagen fibers. Vasa nervorum endothelia and Schwann cells express FGF-2 (nuclear localization) and FSHR (plasma membrane and cytoplasmic staining). Prostate cancer cells invading nerves express VEGF, a critical cytokine in tumor angiogenesis. The vasa nervorum of prostatic nerves with PNI did not express detectable levels of VEGFR-2. No podoplanin-positive lymphatic vessels were seen in nerves. CONCLUSION In locally advanced prostate cancer, PNI of cancer cells is associated with formation of new endoneurial capillaries and changes of vasa nervorum morphology.
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Affiliation(s)
- Nicolae Ghinea
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Blaise Robin
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Christophe Pichon
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Renaud Leclere
- Hôpital Curie, Université de recherche Paris-Sciences-et-Lettres, Pôle de médicine diagnostique et théranostique, Paris, France
| | - André Nicolas
- Hôpital Curie, Université de recherche Paris-Sciences-et-Lettres, Pôle de médicine diagnostique et théranostique, Paris, France
| | - Caroline Chnecker
- Hôpital Lariboisière, Service d'Anatomie et de Cytologie Pathologiques, Paris, France
| | - Jean-François Côté
- Hôpital Pitié-Salpêtrière, Service d'Anatomie et de Cytologie Pathologiques, Paris, France
| | | | - Aurelian Radu
- Icahn School of Medicine at Mount Sinai, Department of Cell, Developmental and Regenerative Biology, New York, New York
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15
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Baumgartner EM, Porter KK, Nix JW, Rais-Bahrami S, Gordetsky JB. Detection of extraprostatic disease and seminal vesicle invasion in patients undergoing magnetic resonance imaging-targeted prostate biopsies. Transl Androl Urol 2018; 7:S392-S396. [PMID: 30363466 PMCID: PMC6178323 DOI: 10.21037/tau.2018.03.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Finding incidental extraprostatic extension (EPE) or seminal vesicle invasion (SVI) by prostate cancer (PCa) is rare on standard prostate biopsy. We evaluated the clinical-pathologic features associated with EPE and SVI on multiparametric magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided targeted biopsy (TB). Methods A retrospective review was performed from 2014-2017, selecting patients who had undergone TB. Clinical, pathologic, and radiologic features were evaluated. Results Five out of 333 (1.5%) patients who had PCa detected on TB had EPE and/or SVI. The average age and prostate-specific antigen (PSA) was 71 years and 17 ng/mL, respectively. The average number of cores taken on TB was 4.2. Two patients had a prior negative SB and two patients had a prior positive SB, one of which underwent radiation therapy. All patients had a PIRADSv2 suspicion score of 4 or 5. Four out of five (80%) patients underwent both SB and concurrent TB, of which 3/4 (75%) had EPE identified only on TB. One out of four (25%) patients also had both EPE and SVI, identified only on TB. One patient underwent only TB for MRI suspicion of SVI, which was pathologically confirmed on TB. On TB, one patient had Grade Group 3, two patients had Grade Group 4, and two patients had Grade Group 5 PCa. Perineural invasion (PNI) was present in 4/5 (80%) patients on TB. Conclusions Based on our small series, we hypothesize that MRI/US fusion TB outperforms SB in the identification of EPE and SVI. However, given the small sample size and the overall rarity of these pathologic findings on prostate biopsy, further validation is needed.
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Affiliation(s)
- Erin M Baumgartner
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristin K Porter
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey W Nix
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Soroush Rais-Bahrami
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer B Gordetsky
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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Kuang AG, Nickel JC, Andriole GL, Castro-Santamaria R, Freedland SJ, Moreira DM. Both acute and chronic inflammation are associated with less perineural invasion in men with prostate cancer on repeat biopsy. BJU Int 2018; 123:91-97. [PMID: 29873889 DOI: 10.1111/bju.14428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the association between acute and chronic inflammation with the presence of perineural invasion (PNI) in prostate biopsies positive for prostate cancer (PCa). MATERIAL AND METHODS We conducted a retrospective analysis of 1 399 prostate biopsies positive for PCa in the Reduction by Dutasteride of PCa Events (REDUCE) study. PCa, acute and chronic prostate inflammation and PNI were assessed by central pathology review. The association between acute and chronic inflammation with PNI was evaluated using chi-squared and Kruskal-Wallis tests, and logistic regression adjusting for clinicopathological and biochemical variables. RESULTS The presence of PNI was identified in 133 biopsies (9.5%). In all, 267 biopsies (19.1%) had acute inflammation, 1 038 (74.2%) had chronic inflammation, and 255 (18.2%) had both. The presence of both acute and chronic inflammation had a mutual association (P < 0.001). Chronic inflammation was associated with a lower Gleason score (P = 0.009) and lower tumour volume (P < 0.001), while acute inflammation was associated with lower Gleason score (P = 0.04), lower tumour volume (P = 0.004) and higher prostate-specific antigen levels (P = 0.05). In both univariable and multivariable analyses, chronic prostate inflammation was significantly associated with less PNI (univariable odds ratio [OR] 0.54, 95% confidence interval [CI] 0.37-0.79, P = 0.001; multivariable OR 0.65, 95% CI 0.43-0.99, P = 0.045). Acute prostate inflammation was associated with less PNI only in univariable analysis (univariable OR 0.51, 95% CI 0.29-0.89, P = 0.018; multivariable OR 0.63, 95% CI 0.35-1.13, P = 0.12). CONCLUSION Acute and chronic prostate inflammation were both associated with a lower prevalence of PNI in prostate biopsies positive for PCa. If confirmed, this suggests that inflammation and immunomodulation can serve as areas of potential therapeutic design to mitigate PNI in patients with PCa.
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Affiliation(s)
- Andrew G Kuang
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | - J Curtis Nickel
- Department of Urology, Queen's University, Kingston, ON, Canada
| | - Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | | | - Stephen J Freedland
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Section of Urology Durham VA Medical Center, Durham, NC, USA
| | - Daniel M Moreira
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
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17
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Wegner KA, Cadena MT, Trevena R, Turco AE, Gottschalk A, Halberg RB, Guo J, McMahon JA, McMahon AP, Vezina CM. An immunohistochemical identification key for cell types in adult mouse prostatic and urethral tissue sections. PLoS One 2017; 12:e0188413. [PMID: 29145476 PMCID: PMC5690684 DOI: 10.1371/journal.pone.0188413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/06/2017] [Indexed: 02/07/2023] Open
Abstract
Though many methods can be used to identify cell types contained in complex tissues, most require cell disaggregation and destroy information about where cells reside in relation to their microenvironment. Here, we describe a polytomous key for cell type identification in intact sections of adult mouse prostate and prostatic urethra. The key is organized as a decision tree and initiates with one round of immunostaining for nerve, epithelial, fibromuscular/hematolymphoid, or vascular associated cells. Cell identities are recursively eliminated by subsequent staining events until the remaining pool of potential cell types can be distinguished by direct comparison to other cells. We validated our identification key using wild type adult mouse prostate and urethra tissue sections and it currently resolves sixteen distinct cell populations which include three nerve fiber types as well as four epithelial, five fibromuscular/hematolymphoid, one nerve-associated, and three vascular-associated cell types. We demonstrate two uses of this novel identification methodology. We first used the identification key to characterize prostate stromal cell type changes in response to constitutive phosphatidylinositide-3-kinase activation in prostate epithelium. We then used the key to map cell lineages in a new reporter mouse strain driven by Wnt10aem1(cre/ERT2)Amc. The identification key facilitates rigorous and reproducible cell identification in prostate tissue sections and can be expanded to resolve additional cell types as new antibodies and other resources become available.
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Affiliation(s)
- Kyle A. Wegner
- George M. O’Brien Benign Urology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Mark T. Cadena
- George M. O’Brien Benign Urology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ryan Trevena
- George M. O’Brien Benign Urology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Anne E. Turco
- George M. O’Brien Benign Urology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Adam Gottschalk
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Richard B. Halberg
- Department of Oncology, McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jinjin Guo
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, W.M. Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America
| | - Jill A. McMahon
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, W.M. Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America
| | - Andrew P. McMahon
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, W.M. Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America
| | - Chad M. Vezina
- George M. O’Brien Benign Urology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
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18
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Sun G, Huang R, Zhang X, Shen P, Gong J, Zhao J, Liu J, Tang Q, Shu K, Yin X, Chen N, Zeng H. The impact of multifocal perineural invasion on biochemical recurrence and timing of adjuvant androgen-deprivation therapy in high-risk prostate cancer following radical prostatectomy. Prostate 2017; 77:1279-1287. [PMID: 28752514 DOI: 10.1002/pros.23388] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 06/22/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Perineural invasion (PNI) is a distinct pathologic entity and a recognized source of tumor spread. However, the role of PNI in high-risk prostate cancer (PCa) has not been explored. The aims of the study were to investigate the impact of PNI on biochemical recurrence (BCR) and optimal timing of adjuvant androgen-deprivation therapy (ADT) after radical prostatectomy (RP). METHODS A total of 265 prostatectomies, median follow-up 45 months, were assessed for the presence and intensity of PNI (unifocal and multifocal) in RP specimens. Kaplan-Meier curves were used to estimate BCR probabilities. Cox proportional hazard models were used to address predictors of BCR. Harrell's C-index was conducted to further validate prognostic value of multi-PNI. RESULTS A total of 123 patients (46.4%) were PNI positive, among which, 91 (74%) and 32 (26%) had unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. The presence of multi-PNI was strongly associated with increasing incidence of BCR (HR = 3.87, 95%CI: 1.66-9.01, P = 0.002). Patients with uni-PNI had a similar BCR rate to those without PNI after adjuvant ADT. For men with multi-PNI, immediate ADT was superior to delayed ADT in decreasing biochemical failure. CONCLUSIONS Our findings suggest that detection of multi-PNI in high-risk RP specimens could be a prognosticator for early biochemical relapse post-surgery. Initiation of adjuvant therapy may be appropriate in patients with multi-PNI as soon as possible after surgery.
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Affiliation(s)
- Guangxi Sun
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Huang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xingming Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Pengfei Shen
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Gong
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jinge Zhao
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiandong Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qidun Tang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Kunpeng Shu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxue Yin
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Ni Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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19
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Ban K, Feng S, Shao L, Ittmann M. RET Signaling in Prostate Cancer. Clin Cancer Res 2017; 23:4885-4896. [PMID: 28490466 DOI: 10.1158/1078-0432.ccr-17-0528] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/24/2017] [Accepted: 05/04/2017] [Indexed: 12/14/2022]
Abstract
Purpose: Large diameter perineural prostate cancer is associated with poor outcomes. GDNF, with its coreceptor GFRα1, binds RET and activates downstream pro-oncogenic signaling. Because both GDNF and GFRα1 are secreted by nerves, we examined the role of RET signaling in prostate cancer.Experimental Design: Expression of RET, GDNF, and/or GFRα1 was assessed. The impact of RET signaling on proliferation, invasion and soft agar colony formation, perineural invasion, and growth in vivo was determined. Cellular signaling downstream of RET was examined by Western blotting.Results: RET is expressed in all prostate cancer cell lines. GFRα1 is only expressed in 22Rv1 cells, which is the only line that responds to exogenous GDNF. In contrast, all cell lines respond to GDNF plus GFRα1. Conditioned medium from dorsal root ganglia contains secreted GFRα1 and promotes transformation-related phenotypes, which can be blocked by anti-GFRα1 antibody. Perineural invasion in the dorsal root ganglion assay is inhibited by anti-GFRα antibody and RET knockdown. In vivo, knockdown of RET inhibits tumor growth. RET signaling activates ERK or AKT signaling depending on context, but phosphorylation of p70S6 kinase is markedly increased in all cases. Knockdown of p70S6 kinase markedly decreases RET induced transformed phenotypes. Finally, RET is expressed in 18% of adenocarcinomas and all three small-cell carcinomas examined.Conclusions: RET promotes transformation associated phenotypes, including perineural invasion in prostate cancer via activation of p70S6 kinase. GFRα1, which is secreted by nerves, is a limiting factor for RET signaling, creating a perineural niche where RET signaling can occur. Clin Cancer Res; 23(16); 4885-96. ©2017 AACR.
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Affiliation(s)
- Kechen Ban
- Department of Pathology & Immunology, Baylor College of Medicine and Michael E. DeBakey Dept. of Veterans Affairs Medical Center, Houston, Texas
| | - Shu Feng
- Department of Pathology & Immunology, Baylor College of Medicine and Michael E. DeBakey Dept. of Veterans Affairs Medical Center, Houston, Texas
| | - Longjiang Shao
- Department of Pathology & Immunology, Baylor College of Medicine and Michael E. DeBakey Dept. of Veterans Affairs Medical Center, Houston, Texas
| | - Michael Ittmann
- Department of Pathology & Immunology, Baylor College of Medicine and Michael E. DeBakey Dept. of Veterans Affairs Medical Center, Houston, Texas.
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20
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Zareba P, Flavin R, Isikbay M, Rider JR, Gerke TA, Finn S, Pettersson A, Giunchi F, Unger RH, Tinianow AM, Andersson SO, Andrén O, Fall K, Fiorentino M, Mucci LA. Perineural Invasion and Risk of Lethal Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2017; 26:719-726. [PMID: 28062398 DOI: 10.1158/1055-9965.epi-16-0237] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 12/12/2022] Open
Abstract
Background: Prostate cancer has a propensity to invade and grow along nerves, a phenomenon called perineural invasion (PNI). Recent studies suggest that the presence of PNI in prostate cancer has been associated with cancer aggressiveness.Methods: We investigated the association between PNI and lethal prostate cancer in untreated and treated prostate cancer cohorts: the Swedish Watchful Waiting Cohort of 615 men who underwent watchful waiting, and the U.S. Health Professionals Follow-Up Study of 849 men treated with radical prostatectomy. One pathologist performed a standardized histopathologic review assessing PNI and Gleason grade. Patients were followed from diagnosis until metastasis or death.Results: The prevalence of PNI was 7% and 44% in the untreated and treated cohorts, respectively. PNI was more common in high Gleason grade tumors in both cohorts. PNI was associated with enhanced tumor angiogenesis, but not tumor proliferation or apoptosis. In the Swedish study, PNI was associated with lethal prostate cancer [OR 7.4; 95% confidence interval (CI), 3.6-16.6; P < 0.001]. A positive, although not statistically significant, association persisted after adjustment for age, Gleason grade, and tumor volume (OR 1.9; 95% CI, 0.8-5.1; P = 0.17). In the U.S. study, PNI predicted lethal prostate cancer independent of clinical factors (HR 1.8; 95% CI, 1.0, 3.3; P =0.04).Conclusions: These data support the hypothesis that perineural invasion creates a microenvironment that promotes cancer aggressiveness.Impact: Our findings suggest that PNI should be a standardized component of histopathologic review, and highlights a mechanism underlying prostate cancer metastasis. Cancer Epidemiol Biomarkers Prev; 26(5); 719-26. ©2017 AACR.
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Affiliation(s)
- Piotr Zareba
- Division of Urology, McMaster University, Hamilton, Ontario, Canada
| | - Richard Flavin
- Department of Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Trinity College Dublin, Dublin, Ireland
| | | | - Jennifer R Rider
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Travis A Gerke
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Stephen Finn
- Department of Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Trinity College Dublin, Dublin, Ireland
| | - Andreas Pettersson
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Clinical Epidemiology Unit, Department of Medicine, Solna, Stockholm, Sweden
| | - Francesca Giunchi
- Pathology Unit, Addarii Institute, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Robert H Unger
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alex M Tinianow
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Swen-Olof Andersson
- Department of Urology, Örebro University Hospital, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Ove Andrén
- Department of Urology, Örebro University Hospital, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Katja Fall
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Michelangelo Fiorentino
- Department of Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Pathology Unit, Addarii Institute, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Lorelei A Mucci
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts. .,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Division of Public Health Sciences, University of Iceland, Reykjavik, Iceland
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21
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Gravina GL, Marampon F, Sanità P, Mancini A, Colapietro A, Scarsella L, Jitariuc A, Biordi L, Ficorella C, Festuccia C. Increased expression and activity of p75NTR are crucial events in azacitidine-induced cell death in prostate cancer. Oncol Rep 2016; 36:125-30. [PMID: 27222100 DOI: 10.3892/or.2016.4832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/15/2015] [Indexed: 11/06/2022] Open
Abstract
The high affinity nerve growth factor (NGF) NGF receptor, p75NTR, is a member of the tumor necrosis factor (TNF) receptor superfamily that shares a conserved intracellular death domain capable of inducing apoptosis and suppressing growth in prostate epithelial cells. Expression of this receptor is lost as prostate cancer progresses and is minimal in established prostate cancer cell lines. We aimed to verify the role of p75NTR in the azacitidine-mediated antitumor effects on 22Rv1 and PC3 androgen-independent prostate cancer cells. In the present study, we reported that the antiproliferative and pro-apoptotic effects of 5-azacytidine (azacitidine) were more marked in the presence of physiological concentrations of NGF and were reduced when a blocking p75NTR antibody or the selective p75NTR inhibitor, Ro 08-2750, were used. Azacitidine increased the expression of p75NTR without interfering with the expression of the low affinity NGF receptor TrkA and induced caspase 9-dependent caspase 3 activity. Taken together, our results suggest that the NGF network could be a candidate for future pharmacological manipulation in aggressive prostate cancer.
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Affiliation(s)
- Giovanni Luca Gravina
- Department of Biotechnological and Applied Clinical Sciences, Division of Radiation Oncology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Francesco Marampon
- Department of Biotechnological and Applied Clinical Sciences, Division of Radiation Oncology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Patrizia Sanità
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Andrea Mancini
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Alessandro Colapietro
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Luca Scarsella
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Ana Jitariuc
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Leda Biordi
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Molecular Oncology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Corrado Ficorella
- Department of Biotechnological and Applied Clinical Sciences, Division of Medical Oncology, University of L'Aquila, I-67100 L'Aquila, Italy
| | - Claudio Festuccia
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, I-67100 L'Aquila, Italy
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22
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Kang M, Oh JJ, Lee S, Hong SK, Lee SE, Byun SS. Perineural Invasion and Lymphovascular Invasion are Associated with Increased Risk of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy. Ann Surg Oncol 2016; 23:2699-706. [PMID: 26965702 DOI: 10.1245/s10434-016-5153-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE This study was designed to determine whether perineural invasion (PNI) and lymphovascular invasion (LVI) are independent predictors for biochemical recurrence (BCR) of prostate cancer (PCa) following radical prostatectomy (RP) in the Asian population. METHODS The study population comprised 2394 PCa patients undergoing RP at our institution in Korea. After excluding 360 patients, we compared the baseline characteristics between the groups according to the presence of PNI or LVI and estimated BCR-free survival using the Kaplan-Meier survival. Multivariate Cox regression model was adopted to identify significant predictive factors of BCR following RP. RESULTS Among 2034 patients, PNI and LVI were detected in 69.3 and 12.4 % patients, respectively. Patients with PNI or LVI had higher rates of advanced biopsy and pathological Gleason score (≥7), and higher proportions of advanced clinical and pathological T stage ≥3, extraprostatic extension, seminal vesicle invasion, and surgical margin positivity. Notably, BCR-free survival was lower in patients with PNI or LVI compared with that in patients without these markers and lower in patients with both markers compared with that in other populations of patients. Moreover, PNI (hazard ratio [HR] = 2.11) and LVI (HR = 1.57) were significant predictors of BCR. The presence of the two markers was associated with a higher risk of BCR (HR = 4.60) compared with the presence of either marker alone (HR = 3.47). CONCLUSIONS PNI and LVI are adverse pathologic parameters and independent predictors for BCR, and the concurrent presence of PNI and LVI resulted in poorer outcomes for BCR in PCa patients who underwent RP.
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Affiliation(s)
- Minyong Kang
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Sang Eun Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
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23
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Moreira DM, Fleshner NE, Freedland SJ. Baseline Perineural Invasion is Associated with Shorter Time to Progression in Men with Prostate Cancer Undergoing Active Surveillance: Results from the REDEEM Study. J Urol 2015; 194:1258-63. [PMID: 25988518 DOI: 10.1016/j.juro.2015.04.113] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We evaluated the association of perineural invasion with disease progression in men with prostate cancer on active surveillance. MATERIALS AND METHODS We retrospectively analyzed the records of 302 men on active surveillance for low risk prostate cancer (T1c-T2a), Gleason 6 or less, 3 or fewer positive cores, 50% or less of any core involved and prostate specific antigen 11 ng/ml or less in the REduction by Dutasteride of clinical progression Events in Expectant Management (REDEEM) study. Patients underwent study mandated biopsies 18 and 36 months after enrollment. Disease progression was divided into pathological (4 or greater positive cores, 50% or greater core involvement, or Gleason greater than 6 on followup biopsy), therapeutic (any therapeutic prostate cancer intervention) or clinical (pathological or therapeutic progression). Time to disease progression was analyzed with Cox models adjusting for patient age, race, baseline prostate specific antigen, number of sampled and involved cores, tumor length and treatment. RESULTS A total of 11 patients (4%) had perineural invasion on baseline biopsy. Perineural invasion was not associated with any baseline features (each p >0.05). During the study clinical progression developed in 125 patients (41%), including pathological progression in 95. One, 2 and 3-year clinical progression-free survival for men with vs without perineural invasion was 82%, 27% and 27% vs 93%, 67% and 58%, respectively (p <0.05). On multivariable analyses perineural invasion was associated with clinical (HR 2.39, 95% CI 1.16-4.94, p = 0.019) and pathological progression (HR 2.21, 95% CI 0.92-5.33, p = 0.076). CONCLUSIONS Among patients with prostate cancer on active surveillance perineural invasion was associated with an increased risk of clinical progression. The 2-year risk of clinical progression with perineural invasion was 73%. If these results are confirmed, patients with perineural invasion may not be good active surveillance candidates.
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Affiliation(s)
| | - Neil E Fleshner
- Division of Urology, Princess Margaret Hospital, University Health Network and Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Stephen J Freedland
- Division of Urology, Department of Surgery and the Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, California; Urology Section, Veterans Affairs Medical Center, Durham, North Carolina
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24
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Prostate biopsy perineural invasion is not independently associated with positive surgical margins following radical retropubic prostatectomy. World J Urol 2014; 33:1269-74. [DOI: 10.1007/s00345-014-1430-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 10/22/2014] [Indexed: 12/18/2022] Open
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25
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He S, He S, Chen CH, Deborde S, Bakst RL, Chernichenko N, McNamara WF, Lee SY, Barajas F, Yu Z, Al-Ahmadie HA, Wong RJ. The chemokine (CCL2-CCR2) signaling axis mediates perineural invasion. Mol Cancer Res 2014; 13:380-90. [PMID: 25312961 DOI: 10.1158/1541-7786.mcr-14-0303] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
UNLABELLED Perineural invasion is a form of cancer progression where cancer cells invade along nerves. This behavior is associated with poor clinical outcomes; therefore, it is critical to identify novel ligand-receptor interactions between nerves and cancer cells that support the process of perineural invasion. A proteomic profiler chemokine array was used to screen for nerve-derived factors secreted from tissue explants of dorsal root ganglion (DRG), and CCL2 was identified as a lead candidate. Prostate cancer cell line expression of CCR2, the receptor to CCL2, correlated closely with MAPK and Akt pathway activity and cell migration towards CCL2 and DRG. In vitro nerve and cancer coculture invasion assays of perineural invasion demonstrated that cancer cell CCR2 expression facilitates perineural invasion. Perineural invasion is significantly diminished in coculture assays when using DRG harvested from CCL2(-/-) knockout mice as compared with control CCL2(+/+) mice, indicating that CCR2 is required for perineural invasion in this murine model of perineural invasion. Furthermore, 20 of 21 (95%) patient specimens of prostate adenocarcinoma with perineural invasion exhibited CCR2 expression by immunohistochemistry, while just 3 of 13 (23%) lacking perineural invasion expressed CCR2. In summary, nerve-released CCL2 supports prostate cancer migration and perineural invasion though CCR2-mediated signaling. IMPLICATIONS These results reveal CCL2-CCR2 signaling as a key ligand-receptor mechanism that mediates cancer cell communication with nerves during perineural invasion and highlight a potential future therapeutic target.
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Affiliation(s)
- Shizhi He
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China
| | - Shuangba He
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Department of Otolaryngology-Head and Neck Surgery, Anhui Provincial Hospital, Anhui Medical University, Anhui, China
| | - Chun-Hao Chen
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Sylvie Deborde
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Richard L Bakst
- Department of Radiation Oncology, Mount Sinai Hospital, New York, New York
| | - Natalya Chernichenko
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - William F McNamara
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Sei Young Lee
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Fernando Barajas
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Zhenkun Yu
- Department of Otolaryngology-Head and Neck Surgery, Nanjing Tongren Hospital, Nanjing, PR China
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Richard J Wong
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
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26
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Craig SEL, Brady-Kalnay SM. Regulation of development and cancer by the R2B subfamily of RPTPs and the implications of proteolysis. Semin Cell Dev Biol 2014; 37:108-18. [PMID: 25223585 DOI: 10.1016/j.semcdb.2014.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 01/04/2023]
Abstract
The initial cloning of receptor protein tyrosine phosphatases (RPTPs) was met with excitement because of their hypothesized function in counterbalancing receptor tyrosine kinase signaling. In recent years, members of a subfamily of RPTPs with homophilic cell-cell adhesion capabilities, known as the R2B subfamily, have been shown to have functions beyond that of counteracting tyrosine kinase activity, by independently influencing cell signaling in their own right and by regulating cell adhesion. The R2B subfamily is composed of four members: PTPmu (PTPRM), PTPrho (PTPRT), PTPkappa (PTPRK), and PCP-2 (PTPRU). The effects of this small subfamily of RPTPs is far reaching, influencing several developmental processes and cancer. In fact, R2B RPTPs are predicted to be tumor suppressors and are among the most frequently mutated protein tyrosine phosphatases (PTPs) in cancer. Confounding these conclusions are more recent studies suggesting that proteolysis of the full-length R2B RPTPs result in oncogenic extracellular and intracellular protein fragments. This review discusses the current knowledge of the role of R2B RPTPs in development and cancer, with special detail given to the mechanisms and implications that proteolysis has on R2B RPTP function. We also touch upon the concept of exploiting R2B proteolysis to develop cancer imaging tools, and consider the effects of R2B proteolysis on axon guidance, perineural invasion and collective cell migration.
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Affiliation(s)
- Sonya E L Craig
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4960, USA
| | - Susann M Brady-Kalnay
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4960, USA; Department of Neurosciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
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27
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Jiang N, Deng JY, Liu Y, Ke B, Liu HG, Liang H. Incorporation of perineural invasion of gastric carcinoma into the 7th edition tumor–node–metastasis staging system. Tumour Biol 2014; 35:9429-36. [DOI: 10.1007/s13277-014-2258-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/18/2014] [Indexed: 12/16/2022] Open
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28
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Twu O, Dessí D, Vu A, Mercer F, Stevens GC, de Miguel N, Rappelli P, Cocco AR, Clubb RT, Fiori PL, Johnson PJ. Trichomonas vaginalis homolog of macrophage migration inhibitory factor induces prostate cell growth, invasiveness, and inflammatory responses. Proc Natl Acad Sci U S A 2014; 111:8179-84. [PMID: 24843155 PMCID: PMC4050605 DOI: 10.1073/pnas.1321884111] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The human-infective parasite Trichomonas vaginalis causes the most prevalent nonviral sexually transmitted infection worldwide. Infections in men may result in colonization of the prostate and are correlated with increased risk of aggressive prostate cancer. We have found that T. vaginalis secretes a protein, T. vaginalis macrophage migration inhibitory factor (TvMIF), that is 47% similar to human macrophage migration inhibitory factor (HuMIF), a proinflammatory cytokine. Because HuMIF is reported to be elevated in prostate cancer and inflammation plays an important role in the initiation and progression of cancers, we have explored a role for TvMIF in prostate cancer. Here, we show that TvMIF has tautomerase activity, inhibits macrophage migration, and is proinflammatory. We also demonstrate that TvMIF binds the human CD74 MIF receptor with high affinity, comparable to that of HuMIF, which triggers activation of ERK, Akt, and Bcl-2-associated death promoter phosphorylation at a physiologically relevant concentration (1 ng/mL, 80 pM). TvMIF increases the in vitro growth and invasion through Matrigel of benign and prostate cancer cells. Sera from patients infected with T. vaginalis are reactive to TvMIF, especially in males. The presence of anti-TvMIF antibodies indicates that TvMIF is released by the parasite and elicits host immune responses during infection. Together, these data indicate that chronic T. vaginalis infections may result in TvMIF-driven inflammation and cell proliferation, thus triggering pathways that contribute to the promotion and progression of prostate cancer.
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Affiliation(s)
| | - Daniele Dessí
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, 07100 Sassari, Italy; and
| | - Anh Vu
- Department of Microbiology, Immunology, and Molecular Genetics, and
| | - Frances Mercer
- Department of Microbiology, Immunology, and Molecular Genetics, and
| | - Grant C Stevens
- Department of Microbiology, Immunology, and Molecular Genetics, and
| | - Natalia de Miguel
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús, 1650 Chascomús, Argentina
| | - Paola Rappelli
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, 07100 Sassari, Italy; and
| | - Anna Rita Cocco
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, 07100 Sassari, Italy; and
| | - Robert T Clubb
- Department of Chemistry and Biochemistry, University of California, Los Angeles, CA 90095
| | - Pier Luigi Fiori
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, 07100 Sassari, Italy; and
| | - Patricia J Johnson
- Molecular Biology Institute,Department of Microbiology, Immunology, and Molecular Genetics, and
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SHEN ZHIYUAN, LI TIANYI, CHEN DA, JIA SEN, YANG XIANGMING, LIANG LIANG, CHAI JUAN, CHENG XIAOBING, YANG XINJIE, SUN MOYI. The CCL5/CCR5 axis contributes to the perineural invasion of human salivary adenoid cystic carcinoma. Oncol Rep 2013; 31:800-6. [DOI: 10.3892/or.2013.2920] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 10/14/2013] [Indexed: 11/05/2022] Open
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30
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Abstract
Perineural invasion (PNI) has attracted attention as a new prognostic factor for cancer. We aimed to investigate the prognostic value of PNI in patients with cervical cancer. Clinical data of 185 patients with early-stage cervical cancer (stages IA2-IIA2) who underwent radical hysterectomy and pelvic lymphadenectomy between 2003 and 2011 were investigated. PNI was detected in 7% (13 of 18 cases) of patients. Moreover, 92% (12 of 13 cases) of patients with PNI received radiation therapy or concurrent chemoradiation therapy after surgery. We investigated whether PNI can be a new indication for adjuvant therapy for cervical cancer. In our study, PNI had a significant association with well-known indications for adjuvant therapy (92.3% sensitivity, 50% specificity, odds ratio 12.0, P = 0.003). Multivariate analysis showed that parametrial invasion and lymphovascular invasion were independently associated with PNI (P < 0.05). However, statistical analysis did not show differences in disease-free survival (P = 0.292) or overall survival (P = 0.346) according to the presence of PNI. In conclusion, PNI as an independent predictor for prognosis was limited, but PNI had a significant association with prognostic factors. PNI may be a new risk factor candidate for cervical cancer. PNI is expected to help in decision making for the need for adjuvant therapy.
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31
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Bründl J, Schneider S, Weber F, Zeman F, Wieland WF, Ganzer R. Computerized quantification and planimetry of prostatic capsular nerves in relation to adjacent prostate cancer foci. Eur Urol 2013; 65:802-8. [PMID: 23711540 DOI: 10.1016/j.eururo.2013.04.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 04/26/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Perineural invasion is discussed as a significant route of extraprostatic extension in prostate cancer (PCa). Recent in vitro studies suggested a complex mechanism of neuroepithelial interaction. OBJECTIVE The present study was intended to investigate whether the concept of neuroepithelial interaction can be supported by a quantitative analysis and planimetry of capsular nerves in relation to adjacent PCa foci. DESIGN, SETTING, AND PARTICIPANTS Whole-mount sections of the prostate were created from patients undergoing non-nerve-sparing laparoscopic radical prostatectomy. For each prostate, adjacent sections were created and stained both to identify capsular nerves (S100) and to localize cancer foci (hematoxylin and eosin). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Computerized quantification and planimetry of capsular nerves (ImageJ software) were performed after applying a digital grid to define 12 capsular sectors. For statistical analyses, mixed linear models were calculated using the SAS 9.3 software package. RESULTS AND LIMITATIONS Specimens of 33 prostates were investigated. A total of 1957 capsular nerves and a total capsular nerve surface area of 26.44 mm(2) were measured. The major proportion was found in the dorsolateral (DL) region (p<0.001). Adjacent tumor was associated with a statistically significant higher capsular nerve count compared with the capsules of tumor-free sectors (p<0.005). Similar results were shown for capsular nerve surface area (p<0.006). Subsequent post hoc analyses at the sector level revealed that the effect of tumor on capsular nerve count or nerve surface area is most pronounced in the DL region. CONCLUSIONS The presence of PCa foci resulted in a significantly increased capsular nerve count and capsular nerve surface area compared with tumor-free sectors. The present study supports former in vitro findings suggesting that the presence of PCa lesions may lead to complex neuroepithelial interactions resulting in PCa-induced nerve growth.
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Affiliation(s)
- Johannes Bründl
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany.
| | - Sebastian Schneider
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany
| | - Florian Weber
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University of Regensburg, Regensburg, Germany
| | - Wolf F Wieland
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany
| | - Roman Ganzer
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany
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Nakamura Y, Felizola SJA, Kurotaki Y, Fujishima F, McNamara KM, Suzuki T, Arai Y, Sasano H. Cyclin D1 (CCND1) expression is involved in estrogen receptor beta (ERβ) in human prostate cancer. Prostate 2013; 73:590-5. [PMID: 23060014 DOI: 10.1002/pros.22599] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 09/11/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Estrogen receptor beta (ERβ) has been demonstrated to be expressed in prostate carcinoma cells and estrogen signals through ERβ to act as a tumor suppressor in prostate cancer patients. ERβ is thought to regulate the cell cycle of prostate carcinoma cells by controlling the expression of cell cycle regulators including cyclin D1 (CCND1). This interaction is of particular interest as CCND1 has been implicated in the development of prostate cancer. METHODS We evaluated ERβ and CCND1 immunoreactivity in human prostate cancer (n = 112, surgical specimens), and correlated the findings with clinicopathological features of the patients. Subsequent in vitro experiments using PC-3 prostate carcinoma cells were also performed to examine whether estradiol (E2) could change the expression level of CCND1 mRNA. RESULTS CCND1 immunoreactivity was detected in 78/112 cases (70%), and was significantly correlated with incidence of perineural invasion and ERβ immunoreactivity (P < 0.05). Forty-eight hours incubation with E2 (10 nM) increased the expression level of CCND1 mRNA as well as c-jun (JUN) and c-fos (FOS) in PC-3 cells, and PHTPP (ERβ antagonist) suppressed E2 -induced expression of those mRNAs. CONCLUSIONS These findings suggest that CCND1 expression is possibly regulated by estrogens via ERβ and that this signaling pathway may influence prostate cancer development.
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Affiliation(s)
- Yasuhiro Nakamura
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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33
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Cozzi G, Rocco BM, Grasso A, Rosso M, Abed El Rahman D, Oliva I, Talso M, Costa B, Tafa A, Palumbo C, Gadda F, Rocco F. Perineural invasion as a predictor of extraprostatic extension of prostate cancer: a systematic review and meta-analysis. Scand J Urol 2013; 47:443-8. [PMID: 23495828 DOI: 10.3109/21681805.2013.776106] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A systematic review of the literature was performed to assess the relationship between the presence of perineural invasion (PNI) at prostate biopsy and extraprostatic extension (EPE) of prostate cancer. In August 2012, Medline, Embase, Scopus and Web of Science databases were searched. A "free-text" protocol using the terms "perineural invasion prostate cancer" was applied. Studies published only as abstracts and reports from meetings were not included in this review. In total, 341 records were retrieved from Medline, 507 from Embase, 374 from Scopus and 65 from the Web of Science database. The records were reviewed to identify studies correlating the presence of PNI with that of EPE. A cumulative analysis was conducted using Review Manager software v. 5.1 (Cochrane Collaboration, Oxford, UK). In univariate analysis, PNI showed a statistically significant association with pT3 tumours (p < 0.00001), which could be observed for both pT3a (p < 0.0001) and pT3b (p < 0.0001). In conclusion, the cumulative analysis shows a statistically significant higher incidence of EPE in patients who had PNI at needle biopsy. The main limitation of the analysis was that it was not possible to perform a multivariate analysis. Further attempts to build a nomogram for the prediction of EPE could include the presence of PNI at needle biopsy.
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Affiliation(s)
- Gabriele Cozzi
- Università degli Studi di Milano, Clinica Urologica I, Fondazione IRCCS, Ca' Granda - Ospedale Maggiore Policlinico , Milan , Italy
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DeLancey JO, Wood DP, He C, Montgomery JS, Weizer AZ, Miller DC, Jacobs BL, Montie JE, Hollenbeck BK, Skolarus TA. Evidence of Perineural Invasion on Prostate Biopsy Specimen and Survival After Radical Prostatectomy. Urology 2013; 81:354-7. [DOI: 10.1016/j.urology.2012.09.034] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 09/25/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
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Tawadros T, Alonso F, Jichlinski P, Clarke N, Calandra T, Haefliger JA, Roger T. Release of macrophage migration inhibitory factor by neuroendocrine-differentiated LNCaP cells sustains the proliferation and survival of prostate cancer cells. Endocr Relat Cancer 2013. [PMID: 23207293 DOI: 10.1530/erc-12-0286] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The acquisition of neuroendocrine (NE) characteristics by prostate cancer (PCa) cells is closely related to tumour progression and hormone resistance. The mechanisms by which NE cells influence PCa growth and progression are not fully understood. Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine involved in oncogenic processes, and MIF serum levels correlate with aggressiveness of PCa. Here, we investigated the regulation and the functional consequences of MIF expression during NE transdifferentiation of PCa cells. NE differentiation (NED) of LNCaP cells, initiated either by increasing intracellular levels of cAMP or by culturing cells in an androgen-depleted medium, was associated with markedly increased MIF release. Yet, intracellular MIF protein and mRNA levels and MIF gene promoter activity decreased during NED of LNCaP cells, suggesting that NED favours MIF release despite decreasing MIF synthesis. Adenoviral-mediated forced MIF expression in NE-differentiated LNCaP cells increased cell proliferation without affecting the expression of NE markers. Addition of exogenous recombinant MIF to LNCaP and PC-3 cells stimulated the AKT and ERK1/2 signalling pathways, the expression of genes involved in PCa, as well as proliferation and resistance to paclitaxel and thapsigargin-induced apoptosis. Altogether, these data provide evidence that increased MIF release during NED in PCa may facilitate cancer progression or recurrence, especially following androgen deprivation. Thus, MIF could represent an attractive target for PCa therapy.
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Affiliation(s)
- Thomas Tawadros
- Service of Urology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon 46, Lausanne, Switzerland.
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