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Del Giudice F, Nowak Ł, Glover F, Ha A, Scott M, Belladelli F, Basran S, Li S, Mulloy E, Pradere B, Asero V, Łaszkiewicz J, Krajewski W, Nair R, Eisenberg ML. 5α-reductase inhibitors with or without alpha-blockers and risk of incident upper tract urothelial carcinoma in men with benign prostatic hyperplasia: Analysis of US insurance claims data. Urol Oncol 2024:S1078-1439(24)00571-4. [PMID: 39244390 DOI: 10.1016/j.urolonc.2024.07.018] [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: 04/30/2024] [Revised: 07/08/2024] [Accepted: 07/29/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Increasing data suggests that androgen receptor signaling may play an important role in the carcinogenesis of urothelial cancers. While the chemoprotective effect of 5-alpha reductase inhibitors (5-ARi) on bladder cancer risk in men with Benign Prostatic Hyperplasia (BPH) has been explored with conflicting results, the evidence regarding 5-ARi treatment, and the risk of incident Upper Tract Urothelial Carcinoma (UTUC) development is lacking. Therefore, our objective was to investigate the impact of the 5-ARi administration on the incidence of new UTUC cases using a large US database. METHODS The MerativeTM Marketscan® database was used to identify men ≥ 50 years old with a diagnosis of BPH and an active 5-ARi prescription between 2007 and 2021 and were subsequently matched with paired controls. A multivariable Cox regression model was implemented to ascertain the association of 5-ARi and/or alpha-blocker (α-B) medications on the incidence of UTUC. Additional subgroup analyses were conducted based on exposure risk (with a 2-year threshold) to investigate the relationship between 5-ARi and UTUC over time. RESULTS Overall, n=1,103,743 men BPH without prescriptions for BPH, n=31,142 men on 5-ARi, and n=160,049 using 5-ARi + α-B were identified. Over the follow-up period, a total of n=4,761 patients were diagnosed with UTUC. After matching, UTUC incidence ranged from 0.36% to 0.41% in men without active BPH therapy vs. 0.30% and 0.52% for the 5-ARi and 5-ARi + α-B groups, respectively. In multivariable analysis, the chemoprotective effect on UTUC risk was not observed for either 5-ARi monotherapy (adjusted hazard ratio [aHR]: 0.91, 95% CI: 0.58-1.44) or 5-ARi + α-B combination (aHR: 1.02, 95% CI: 0.87-1.19). This remained true for both short-term (≤ 2 years) and long-term (> 2 years) follow-up periods. CONCLUSIONS The use of 5-ARi for BPH, whether used alone or in combination with α-B, is not associated with incident UTUC.
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Affiliation(s)
- Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy. Viale del Policlinico 155, 00161, Rome, Italy; Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
| | - Łukasz Nowak
- Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50 367 Wrocław, Poland
| | - Frank Glover
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA,USA
| | - Albert Ha
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Scott
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Federico Belladelli
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA; University Vita-Salute San Rafaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Satvir Basran
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Shufeng Li
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA; Department of Dermatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Evan Mulloy
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Benjamin Pradere
- Department of Urology, Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy. Viale del Policlinico 155, 00161, Rome, Italy
| | - Jan Łaszkiewicz
- Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50 367 Wrocław, Poland
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50 367 Wrocław, Poland
| | - Rajesh Nair
- Department of Urology, Guys and St, Thomas' NHS Foundation Trust, London, UK
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
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2
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Goto T, Miyamoto H. The Role of Estrogen Receptors in Urothelial Cancer. Front Endocrinol (Lausanne) 2021; 12:643870. [PMID: 33796076 PMCID: PMC8008958 DOI: 10.3389/fendo.2021.643870] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
Epidemiological data have indicated that there are some sex-related differences in bladder cancer. Indeed, the incidence of bladder cancer in men has been substantially higher than that in women throughout the world, while women tend to have higher stage disease and poorer prognosis. These gender disparities have prompted to investigate sex hormones and their cognitive receptors in bladder cancer. Specifically, estrogen receptors, including estrogen receptor-α and estrogen receptor-β, have been shown to contribute to urothelial carcinogenesis and cancer progression, as well as to modulating chemosensitivity in bladder cancer, although conflicting findings exist. Meanwhile, immunohistochemical studies in surgical specimens have assessed the expression of estrogen receptors and related proteins as well as its associations with clinicopathologic features of bladder cancer and patient outcomes. This review article summarizes and discusses available data indicating that estrogen receptor signaling plays an important role in urothelial cancer.
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Affiliation(s)
- Takuro Goto
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, United States
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Hiroshi Miyamoto
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, United States
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
- Department of Urology, University of Rochester Medical Center, Rochester, NY, United States
- *Correspondence: Hiroshi Miyamoto,
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3
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Sanguedolce F, Cormio L, Carrieri G, Calò B, Russo D, Menin A, Pastore AL, Greco F, Bozzini G, Galfano A, Pini G, Porreca A, Mugavero F, Falsaperla M, Ceruti C, Cindolo L, Antonelli A, Minervini A. Role of androgen receptor expression in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. Histol Histopathol 2019; 35:423-432. [PMID: 31803932 DOI: 10.14670/hh-18-189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In order to evaluate the potential prognostic/predictive role of androgen receptor (AR) expression in non-muscle-invasive bladder cancer (NMIBC), and whether it may represent a therapeutic target, we conducted a systematic search of the literature using 'androgen receptor or AR', 'testosterone', 'bladder cancer' and 'non-muscle invasive bladder cancer or NMIBC' as keywords. Eleven studies met the inclusion/exclusion criteria. No significant association was found between AR status and patients' gender (p=0.232), tumor size (p=0.975), tumor stage (p=0.237), tumor grade (p=0.444), tumor multicentricity (p=0.397), concomitant CIS (p=0.316) and progression of disease (p=0.397). On the other hand, relative lack of AR expression was significantly correlated to recurrent disease (p=0.001). Evidence for a direct correlation between AR expression and recurrence-free survival of patients with NMIBC indicate ARs as potential markers of BC behavior; moreover, the finding of a role of androgen blockade therapy in improving survival highlights the potential clinical application of this pathway, which deserves to be further explored.
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Affiliation(s)
- Francesca Sanguedolce
- Department of Pathology, University Hospital, Foggia, Italy. .,AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Beppe Calò
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Davide Russo
- Department of Pathology, University Hospital, Foggia, Italy
| | - Andrea Menin
- Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - Antonio Luigi Pastore
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit, Sapienza University of Rome, Latina, Italy
| | - Francesco Greco
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, Humanitas Gavazzeni, Bergamo, Italy
| | - Giorgio Bozzini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASST Valle Olona, Busto A. (VA), Italy
| | - Antonio Galfano
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovannalberto Pini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Angelo Porreca
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Policlinico of Abano, Abano Terme, Italy
| | - Filippo Mugavero
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Ospedale Vittorio Emanuele, Catania, Italy
| | - Mario Falsaperla
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Ospedale Vittorio Emanuele, Catania, Italy
| | - Carlo Ceruti
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Clinic, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Luca Cindolo
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASL02 Abruzzo, Chieti, Italy
| | - Alessandro Antonelli
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, ASST-Spedali Civili, Brescia, Italy
| | - Andrea Minervini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
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4
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Inoue S, Mizushima T, Miyamoto H. Role of the androgen receptor in urothelial cancer. Mol Cell Endocrinol 2018; 465:73-81. [PMID: 28652170 DOI: 10.1016/j.mce.2017.06.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 12/22/2022]
Abstract
Men have had a substantially higher risk of developing bladder cancer than women. This has prompted research on androgen-mediated androgen receptor (AR) signaling in urothelial cancer. Indeed, increasing preclinical evidence indicates that AR activation correlates with the promotion of urothelial carcinogenesis and tumor outgrowth. In this article, we summarize and discuss available data suggesting the involvement of androgens and the AR pathway in the development and progression of urothelial cancer. Although precise mechanisms for the functions of AR and related signals in urothelial cells remain far from being fully understood, current observations may offer effective chemopreventive and therapeutic approaches for urothelial cancer. Clinical application of various anti-AR therapies available for AR-dependent prostate cancer to urothelial cancer patients is thus anticipated.
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Affiliation(s)
- Satoshi Inoue
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Taichi Mizushima
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Hiroshi Miyamoto
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Department of Urology, University of Rochester Medical Center, Rochester, NY, USA.
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5
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Reubi JC. In Vitro Evaluation of Molecular Tumor Targets in Nuclear Medicine: Immunohistochemistry Is One Option, but Under Which Conditions? J Nucl Med 2017; 58:1885-1887. [PMID: 28912151 DOI: 10.2967/jnumed.117.197582] [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: 06/14/2017] [Accepted: 08/10/2017] [Indexed: 11/16/2022] Open
Abstract
The identification of new molecular targets for diagnostic and therapeutic applications using in vitro methods is an important challenge in nuclear medicine. One such method is immunohistochemistry, increasingly popular because it is easy to perform. This review presents the case for conducting receptor immunohistochemistry to evaluate potential molecular targets in human tumor tissue sections. The focus is on the immunohistochemistry of G-protein-coupled receptors, one of the largest families of cell surface proteins, representing a major class of drug targets and thus playing an important role in nuclear medicine. This review identifies common pitfalls and challenges and provides guidelines on performing such immunohistochemical studies. An appropriate validation of the target is a prerequisite for developing robust and informative new molecular probes.
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6
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GATA3 immunohistochemistry in urothelial carcinoma of the upper urinary tract as a urothelial marker and a prognosticator. Hum Pathol 2017; 64:83-90. [DOI: 10.1016/j.humpath.2017.04.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/21/2017] [Accepted: 04/02/2017] [Indexed: 12/20/2022]
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7
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Patnaik SS, Laganà AS, Vitale SG, Butticè S, Noventa M, Gizzo S, Valenti G, Rapisarda AMC, La Rosa VL, Magno C, Triolo O, Dandolu V. Etiology, pathophysiology and biomarkers of interstitial cystitis/painful bladder syndrome. Arch Gynecol Obstet 2017; 295:1341-1359. [DOI: 10.1007/s00404-017-4364-2] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/30/2017] [Indexed: 12/30/2022]
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8
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Ide H, Inoue S, Miyamoto H. Histopathological and prognostic significance of the expression of sex hormone receptors in bladder cancer: A meta-analysis of immunohistochemical studies. PLoS One 2017; 12:e0174746. [PMID: 28362839 PMCID: PMC5375178 DOI: 10.1371/journal.pone.0174746] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/14/2017] [Indexed: 12/26/2022] Open
Abstract
Objective Emerging preclinical evidence suggests the involvement of sex hormones and their receptor signals in the development and progression of bladder cancer. Meanwhile, previous studies have demonstrated conflicting results on the relationship between the status of sex hormone receptors in urothelial tumors and histopathological characteristics of the tumors or patient outcomes. We therefore conducted this meta-analysis to assess the clinicopathological impact of the expression of androgen receptor (AR) and estrogen receptors (ERs) in bladder cancer. Methods A comprehensive literature search in databases (i.e. PubMed, Web of Science, Cochrane) was performed for all immunohistochemical studies stained for AR, ERα, and/or ERβ in surgically resected bladder cancer specimens and analyzed for patient outcomes. We selected eligible studies in accordance with the PRISMA guidelines and analyzed data using R software. Results A total of 2,049 patients from 13 retrospective studies were included in this meta-analysis. The difference in ERα expression between non-tumors and tumors was significant [odds ratio (OR) = 0.412; P<0.001], while those of AR (OR = 3.256; P = 0.336) or ERβ (OR = 0.580; P = 0.674) were not statistically significant. AR positivity in tumors was strongly correlated with gender (male vs. female: OR = 0.658; P = 0.027) or tumor grade (low-grade vs. high-grade: OR = 0.575; P<0.001). ERβ positive rates were significantly higher in high-grade (OR = 2.169; P<0.001) and muscle-invasive (OR = 3.104; P<0.001) tumors than in low-grade and non-muscle-invasive tumors, respectively. Survival analysis in patients with non-muscle-invasive bladder cancer revealed associations between AR expression and better recurrence-free survival [hazard ration (HR) = 0.593; P = 0.006) as well as between ERβ expression and worse recurrence-free (HR = 1.573; P = 0.013) or progression-free (HR = 4.148; P = 0.089) survivals. Conclusions These data suggest down-regulation of ERα expression in bladder tumors, compared with non-neoplastic urothelial tissues. AR or ERβ expression was down- or up-regulated, respectively, in high-grade and/or muscle-invasive bladder cancers. Moreover, immunohistochemistry of AR/ERβ in surgical specimens may serve as prognosticators in patients with non-muscle-invasive bladder tumor.
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Affiliation(s)
- Hiroki Ide
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Satoshi Inoue
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
- The Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Hiroshi Miyamoto
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- The Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
- The Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States of America
- Department Urology, University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail:
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9
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Kawahara T, Inoue S, Fujita K, Mizushima T, Ide H, Yamaguchi S, Fushimi H, Nonomura N, Miyamoto H. NFATc1 Expression as a Prognosticator in Urothelial Carcinoma of the Upper Urinary Tract. Transl Oncol 2017; 10:318-323. [PMID: 28327458 PMCID: PMC5358926 DOI: 10.1016/j.tranon.2017.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/30/2022] Open
Abstract
We recently found that NFATc1, a member of the NFAT family and a key regulator of the immune response, could induce bladder carcinogenesis and cancer progression. In this study, we immunohistochemically stained for NFATc1 in upper urinary tract urothelial carcinoma (UUTUC) specimens and paired nonneoplastic urothelial tissues. NFATc1 was positive in 51 [52%; 40 (40%) weak (1+), 9 (9%) moderate (2+), and 2 (2%) strong (3+)] of 99 UUTUCs, which was significantly higher than in benign urothelium [30 (36%) of 83; 28 (34%) weak and 2 (2%) moderate] (0 vs 1+/2+/3+, P=.038; 0/1+ vs 2+/3+, P=.023). There were no significant associations between NFATc1 expression pattern and tumor grade or pT stage. However, the positive rates of NFATc1 expression tended to be higher in renal pelvic tumors (60%) than in ureteral tumors (42%; P=.080) as well as in pN+ tumors (75%) than in pN0 tumors (49%; P=.089). Kaplan-Meier and log-rank tests revealed that moderate (2+) to strong (3+) NFATc1 expression correlated with lower progression-free survival (P=.032) and cancer-specific survival (P=.005) rates in the 99 cases. Patients with high (2+/3+) NFATc1 muscle-invasive tumor (n=9) also had a significantly higher risk of cancer-specific mortality (P=.021) compared to those with low (0/1+) NFATc1 muscle-invasive tumor (n=53). Thus, compared with nonneoplastic urothelium, a significant increase in the expression of NFATc1 in UUTUC was seen, implying the involvement of NFATc1 signals in the development of UUTUC. The current results further suggest that NFATc1 overexpression serves as a predictor of poor prognosis in patients with UUTUC.
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Affiliation(s)
- Takashi Kawahara
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Inoue
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Kazutoshi Fujita
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taichi Mizushima
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Hiroki Ide
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seiji Yamaguchi
- Department of Urology, Osaka General Medical Center, Osaka, Japan
| | - Hiroaki Fushimi
- Department of Pathology, Osaka General Medical Center, Osaka, Japan
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroshi Miyamoto
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA; James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA; Department of Urology, University of Rochester Medical Center, Rochester, NY, USA.
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10
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Androgen Receptor Signaling in Bladder Cancer. Cancers (Basel) 2017; 9:cancers9020020. [PMID: 28241422 PMCID: PMC5332943 DOI: 10.3390/cancers9020020] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/24/2017] [Accepted: 02/16/2017] [Indexed: 01/21/2023] Open
Abstract
Emerging preclinical findings have indicated that steroid hormone receptor signaling plays an important role in bladder cancer outgrowth. In particular, androgen-mediated androgen receptor signals have been shown to correlate with the promotion of tumor development and progression, which may clearly explain some sex-specific differences in bladder cancer. This review summarizes and discusses the available data, suggesting the involvement of androgens and/or the androgen receptor pathways in urothelial carcinogenesis as well as tumor growth. While the precise mechanisms of the functions of the androgen receptor in urothelial cells remain far from being fully understood, current evidence may offer chemopreventive or therapeutic options, using androgen deprivation therapy, in patients with bladder cancer.
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11
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Mizushima T, Tirador KA, Miyamoto H. Androgen receptor activation: a prospective therapeutic target for bladder cancer? Expert Opin Ther Targets 2017; 21:249-257. [PMID: 28064545 DOI: 10.1080/14728222.2017.1280468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Patients with non-muscle-invasive or muscle-invasive bladder cancer undergoing surgery and currently available conventional therapy remain having a high risk of tumor recurrence or progression, respectively. Novel targeted molecular therapy is therefore expected to improve patient outcomes. Meanwhile, substantially higher incidence of bladder cancer in men has prompted research on androgen-mediated androgen receptor (AR) signaling in this malignancy. Indeed, preclinical evidence has suggested that AR signaling plays an important role in urothelial carcinogenesis and tumor outgrowth as well as resistance to some of the currently available conventional non-surgical therapies. Areas covered: We summarize and discuss available data suggesting the involvement of AR and its potential downstream targets in the development and progression of bladder cancer. Associations between AR signaling and sensitivity to cisplatin/doxorubicin or bacillus Calmette-Guérin treatment are also reviewed. Expert opinion: AR activation is likely to correlate with the promotion of urothelial carcinogenesis and cancer outgrowth as well as resistance to conventional therapies. Molecular therapy targeting the AR may thus provide effective chemopreventive and therapeutic approaches for urothelial cancer. Accordingly, bladder cancer can now be considered as an endocrine-related neoplasm. Clinical application of various anti-AR therapies available for AR-dependent prostate cancer to bladder cancer patients is anticipated.
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Affiliation(s)
- Taichi Mizushima
- a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA.,b Wilmot Cancer Institute , University of Rochester Medical Center , Rochester , NY , USA
| | - Kathleen A Tirador
- a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA
| | - Hiroshi Miyamoto
- a Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA.,b Wilmot Cancer Institute , University of Rochester Medical Center , Rochester , NY , USA.,c Department of Urology , University of Rochester Medical Center , Rochester , NY , USA
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12
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Wirth GJ, Haitel A, Moschini M, Soria F, Klatte T, Hassler MR, Bensalah K, Briganti A, Karam JA, Lotan Y, Margulis V, Raman JD, Remzi M, Rioux-Leclercq N, Robinson BD, Rouprêt M, Wood CG, Shariat SF. Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract. World J Urol 2016; 35:943-949. [PMID: 27730305 DOI: 10.1007/s00345-016-1946-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/27/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC). METHODS AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). RESULTS Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS. CONCLUSIONS In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.
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Affiliation(s)
- G J Wirth
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Division of Urology, Department of Surgery, Geneva University Hospital, Geneva, Switzerland
| | - A Haitel
- Department of Clinical Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Moschini
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - F Soria
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy
| | - T Klatte
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Karl-Landsteiner Institute for Urology and Andrology, Vienna, Austria
| | - M R Hassler
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - K Bensalah
- Department of Urology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - A Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - J A Karam
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Y Lotan
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - V Margulis
- Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J D Raman
- Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - M Remzi
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - N Rioux-Leclercq
- Department of Pathology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - B D Robinson
- Department of Pathology, Weill Cornell Medical College, New York, NY, USA
| | - M Rouprêt
- Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France
| | - C G Wood
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Department of Urology, Weill Cornell Medical College, New York, NY, USA.
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13
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Kashiwagi E, Fujita K, Yamaguchi S, Fushimi H, Ide H, Inoue S, Mizushima T, Reis LO, Sharma R, Netto GJ, Nonomura N, Miyamoto H. Expression of steroid hormone receptors and its prognostic significance in urothelial carcinoma of the upper urinary tract. Cancer Biol Ther 2016; 17:1188-1196. [PMID: 27635763 DOI: 10.1080/15384047.2016.1235667] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
To assess the expression status of steroid hormone receptors in upper urinary tract urothelial carcinoma (UUTUC), we immunohistochemically stained for androgen receptor (AR), estrogen receptor-α (ERα), ERβ, glucocorticoid receptor (GR), and progesterone receptor (PR) in 99 UUTUC specimens and paired non-neoplastic urothelial tissues. AR/ERα/ERβ/GR/PR was positive in 20%/18%/62%/63%/16% of tumors, which was significantly lower (except PR) than in benign urothelial tissues [57% (P < 0.001)/40% (P = 0.001)/85% (P = 0.001)/84% (P = 0.002)/13% (P = 0.489)]. There were no significant associations between each receptor expression pattern and histopathological characteristic of the tumors including tumor grade/stage. Kaplan-Meier and log-rank tests revealed no significant prognostic value of each receptor expression in these 99 patients. However, patients with UUTUC positive for either ERα or PR had a significantly higher risk of disease-specific mortality (P = 0.025), compared with those with UUTUC negative for both. PR positivity alone in pT3 or pT4 tumors was also strongly associated with the risk of disease-specific mortality (P = 0.040). Multivariate analysis further identified the expression of ERα and/or PR as a strong predictor for disease-specific mortality in the entire cohort of the patients (hazard ratio, 2.434; P = 0.037). Thus, in accordance with previous observations in bladder specimens, significant decreases in the expression of AR/ERα/ERβ/GR in UUTUC, compared with that in non-neoplastic urothelium, were observed. Meanwhile, the negativity of both ERα and PR in UUTUC as well as the negativity of PR alone in deeply invasive tumor was suggested to serve as a prognosticator.
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Affiliation(s)
- Eiji Kashiwagi
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Kazutoshi Fujita
- c Department of Urology , Osaka University Graduate School of Medicine , Suita , Japan
| | - Seiji Yamaguchi
- d Department of Urology , Osaka General Medical Center , Osaka , Japan
| | - Hiroaki Fushimi
- e Department of Pathology , Osaka General Medical Center , Japan
| | - Hiroki Ide
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Satoshi Inoue
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,f Department of Pathology & Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA.,g Wilmot Cancer Institute, University of Rochester Medical Center , Rochester , NY , USA
| | - Taichi Mizushima
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,f Department of Pathology & Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA.,g Wilmot Cancer Institute, University of Rochester Medical Center , Rochester , NY , USA
| | - Leonardo O Reis
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Rajni Sharma
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - George J Netto
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Norio Nonomura
- c Department of Urology , Osaka University Graduate School of Medicine , Suita , Japan
| | - Hiroshi Miyamoto
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,b Department of Urology , Johns Hopkins University School of Medicine , Baltimore , MD , USA.,f Department of Pathology & Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA.,g Wilmot Cancer Institute, University of Rochester Medical Center , Rochester , NY , USA.,h Department of Urology , University of Rochester Medical Center , Rochester , NY , USA
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14
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Lucca I, Klatte T, Fajkovic H, de Martino M, Shariat SF. Gender differences in incidence and outcomes of urothelial and kidney cancer. Nat Rev Urol 2016; 12:585-92. [PMID: 26436686 DOI: 10.1038/nrurol.2015.232] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A gender discrepancy exists in the incidence of both urothelial and kidney carcinomas, with more men presenting with these cancers than women. Men have a threefold greater risk of developing bladder cancer than women, but female gender has been identified as an independent adverse prognostic factor for both recurrence and progression of this disease. In particular, women with bladder cancer are often diagnosed with a higher tumour stage than men. Conclusive data on the influence of gender on outcomes of patients with upper tract urothelial carcinoma are currently lacking, although men seem to have a higher disease incidence, whereas survival outcomes might be independent of gender. Patients with renal cell carcinoma are more often men and they typically have larger tumours and higher stage and grade disease than women with this cancer. Smoking habits, tumour biology, occupational risk factors and sex steroid hormones and their receptors could have a role in these observed gender disparities. The majority of data support the theory that gender influences incidence and prognosis of urothelial and kidney cancers; men and women are different genetically and socially, making the consideration of gender a key factor in the clinical decision-making process. Thus, the inclusion of this variable in validated prognostic tables and nomograms should be discussed as a matter of importance.
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Affiliation(s)
- Ilaria Lucca
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Tobias Klatte
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Harun Fajkovic
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Michela de Martino
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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15
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Ide H, Miyamoto H. Steroid Hormone Receptor Signals as Prognosticators for Urothelial Tumor. DISEASE MARKERS 2015; 2015:840640. [PMID: 26770009 PMCID: PMC4685115 DOI: 10.1155/2015/840640] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 11/18/2015] [Indexed: 12/18/2022]
Abstract
There is a substantial amount of preclinical or clinical evidence suggesting that steroid hormone receptor-mediated signals play a critical role in urothelial tumorigenesis and tumor progression. These receptors include androgen receptor, estrogen receptors, glucocorticoid receptor, progesterone receptor, vitamin D receptor, retinoid receptors, peroxisome proliferator-activated receptors, and others including orphan receptors. In particular, studies using urothelial cancer tissue specimens have demonstrated that elevated or reduced expression of these receptors as well as alterations of their upstream or downstream pathways correlates with patient outcomes. This review summarizes and discusses available data suggesting that steroid hormone receptors and related signals serve as biomarkers for urothelial carcinoma and are able to predict tumor recurrence or progression.
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Affiliation(s)
- Hiroki Ide
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hiroshi Miyamoto
- Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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16
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Ha YS, Lee GT, Modi P, Kwon YS, Ahn H, Kim WJ, Kim IY. Increased Expression of Androgen Receptor mRNA in Human Renal Cell Carcinoma Cells is Associated with Poor Prognosis in Patients with Localized Renal Cell Carcinoma. J Urol 2015; 194:1441-8. [PMID: 25796113 DOI: 10.1016/j.juro.2015.03.078] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The role of androgen receptor in renal cell carcinoma is not well understood. In this study the correlation between androgen receptor mRNA expression and clinicopathological features in patients with localized renal cell carcinoma was investigated. Additionally, human renal cell carcinoma cell lines were examined for the presence and effect of androgen receptor. MATERIALS AND METHODS Androgen receptor mRNA expression was evaluated by quantitative real-time polymerase chain reaction in 115 tumor samples from patients with primary pathological stage T1 or T2 (pT1/pT2) renal cell carcinoma and 57 specimens of corresponding normal kidney tissue. Reverse transcriptase-polymerase chain reaction and Western blot were done to examine the expression of androgen receptor in human renal cell carcinoma cell lines. Effects on cellular proliferation were investigated after activating and blocking androgen signaling in tissue culture. RESULTS Androgen receptor mRNA expression levels were significantly higher in patients with pT2 tumors than in those with pT1 tumors (p = 0.011). Kaplan-Meier estimates revealed significant differences in time to progression and cancer specific survival between low and high androgen receptor mRNA expression groups regardless of gender. Multivariate Cox regression analysis demonstrated that the level of androgen receptor expression was an independent predictor of cancer specific survival (HR 15.546, 95% CI 1.320-183.131, p = 0.029). In tissue culture treatment with dihydrotestosterone caused proliferation in androgen receptor positive cell lines while enzalutamide resulted in reduced cell viability in a dose dependent manner. CONCLUSIONS In patients with localized renal cell carcinoma the androgen receptor mRNA expression level is associated with prognosis. In addition, cell culture data suggest that enzalutamide may have an effect in limiting the growth of androgen receptor positive renal cell carcinoma.
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Affiliation(s)
- Yun-Sok Ha
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Department of Urology, Kyungpook National University, Daegu, Republic of Korea
| | - Geun Taek Lee
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Parth Modi
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Young Suk Kwon
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Hanjong Ahn
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Isaac Yi Kim
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
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17
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Reubi JC. Strict rules are needed for validation of G-protein-coupled receptor immunohistochemical studies in human tissues. Endocrine 2014; 47:659-61. [PMID: 24913418 DOI: 10.1007/s12020-014-0320-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/23/2014] [Indexed: 12/17/2022]
Affiliation(s)
- Jean Claude Reubi
- Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Berne, Murtenstrasse 31, PO Box 62, 3010, Berne, Switzerland,
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18
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Androgen receptor immunohistochemistry in genitourinary neoplasms. Int Urol Nephrol 2014; 47:81-5. [PMID: 25218615 DOI: 10.1007/s11255-014-0834-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 08/29/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE Androgen receptor (AR) is a recognized immunohistochemical marker of prostate cancer. However, the sensitivity and specificity of AR for prostate cancer in the setting of other genitourinary neoplasms has not been rigorously studied. METHODS We employed tissue microarrays containing prostate carcinomas, urothelial carcinomas, renal cell carcinomas, and testicular neoplasms. Slides were stained immunohistochemically for AR. RESULTS Androgen receptor was positive in 95% of prostate carcinomas (n=230), but 19% of invasive urothelial carcinomas of the bladder (n=190) and 33% of non-invasive bladder urothelial carcinomas were also AR positive (N=107). Furthermore, 16% of renal pelvis urothelial carcinomas (n=43) were positive. Of primary renal cell carcinomas, 19% were AR positive (n=307). From a metastatic renal cell carcinoma cohort, 28% of metastases were AR positive (N=126). Six percent of non-teratomatous testicular germ cell tumors stained for AR (n=103). CONCLUSIONS Our data show that the sensitivity of AR immunohistochemistry for prostate cancer is 94.8%. However, the specificity of AR is only 81.4%, among our cohort of invasive genitourinary tumors. Thus, we find the specificity of AR suboptimal, yet AR may remain useful as a component of an immunostain panel.
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19
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Acetylation status of P53 and the expression of DBC1, SIRT1, and androgen receptor are associated with survival in clear cell renal cell carcinoma patients. Pathology 2014; 45:574-80. [PMID: 24018803 DOI: 10.1097/pat.0b013e3283652c7a] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS Recently, the important role of silent mating type information regulation 2 homolog 1 (SIRT1) and deleted in breast cancer 1 (DBC1) in human cancer has been extensively studied and their role has been closely related with the control of P53 and androgen receptor (AR) functions. However, their role in clear cell renal cell carcinoma (CRCC) is still unknown. METHODS We evaluated the expression of SIRT1, P53, acetylated-P53, DBC1 and AR and their prognostic significance in 200 CRCC patients. RESULTS The expression of SIRT1, P53, DBC1, and AR significantly correlated with each other and all of them predicted shorter overall survival (OS), relapse-free survival (RFS), and cancer-specific survival (CSS). In contrast, the expression of acetylated-P53 predicted favourable OS, RFS, and CSS. Combined expression pattern of acetylated-P53 and P53 (Ac-P53/P53) also closely correlated with survival of CRCC patients. Multivariate analysis revealed DBC1, acetylated-P53, and Ac-P53/P53 expression as independent prognostic indicators for OS and RFS, and Ac-P53 expression as an independent prognostic indicator for CSS. CONCLUSIONS This study demonstrates that the acetylation status of P53 and the expression of SIRT1, DBC1, and AR could be new prognostic indicators for CRCC and suggest that SIRT1-P53 and DBC1-AR related pathways could be new therapeutic targets for the treatment of CRCC.
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20
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Francomano D, Lenzi A, Aversa A. Effects of five-year treatment with testosterone undecanoate on metabolic and hormonal parameters in ageing men with metabolic syndrome. Int J Endocrinol 2014; 2014:527470. [PMID: 24688542 PMCID: PMC3945028 DOI: 10.1155/2014/527470] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/05/2013] [Indexed: 01/10/2023] Open
Abstract
Metabolic and hormonal modifications after long-term testosterone (T) treatment have never been investigated. 20 hypogonadal men (mean T = 241 ng/dL-8.3 nmol/L) with metabolic syndrome (MS, mean age 58) were treated with T-undecanoate injections every 12 weeks for 60 months. 20 matched subjects in whom T was unaccepted or contraindicated served as controls. Primary endpoints were variations from baseline of metabolic and hormonal parameters. In T-group, significant reductions in waist circumference (-9.6 ± 3.8 cm, P < 0.0001), body weight (-15 ± 2.8 Kg, P < 0.0001), and glycosylated hemoglobin (-1.6 ± 0.5%, P < 0.0001) occurred, along with improvements in insulin sensitivity (HOMA-I; -2.8 ± 0.6, P < 0.0001), lipid profile (total/HDL-cholesterol ratio -2.9 ± 1.5, P < 0.0001), systolic and diastolic blood pressure (-23 ± 10 and -16 ± 8 mm Hg, P < 0.0001, resp.), and neck and lumbar T-scores (+0.5 ± 0.15 gr/cm(2), P < 0.0001; +0.7 ± 0.8, P < 0.0001, resp.). Also, serum vitamin D (+14.0 ± 1.3 ng/mL, P < 0.01), TSH (- 0.9 ± 0.3 mUI/mL, P < 0.01), GH (0.74 ± 0.2 ng/mL, P < 0.0001), and IGF1 (105 ± 11 ng/mL, P < 0.01) levels changed in T-group but not in controls. Normalization of T levels in men with MS improved obesity, glycemic control, blood pressure, lipid profile, and bone mineral density compared with controls. Amelioration in hormonal parameters, that is, vitamin D, growth hormone, and thyrotropin plasma levels, were reported.
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Affiliation(s)
- Davide Francomano
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Antonio Aversa
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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21
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Chang C, Lee SO, Yeh S, Chang TM. Androgen receptor (AR) differential roles in hormone-related tumors including prostate, bladder, kidney, lung, breast and liver. Oncogene 2013; 33:3225-34. [PMID: 23873027 DOI: 10.1038/onc.2013.274] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/09/2013] [Accepted: 05/13/2013] [Indexed: 02/07/2023]
Abstract
The androgen receptor (AR) is expressed in many cell types and the androgen/AR signaling has been found to have important roles in modulating tumorigenesis and metastasis in several cancers including prostate, bladder, kidney, lung, breast and liver. However, whether AR has differential roles in the individual cells within these tumors that contain a variety of cell types remains unclear. Generation of AR knockout (ARKO) mouse models with deletion of AR in selective cells within tumors indeed have uncovered many unique AR roles in the individual cell types during cancer development and progression. This review will discuss the results obtained from various ARKO mice and different human cell lines with special attention to the cell type- and tissue-specific ARKO models. The understanding of various results showing the AR indeed has distinct and contrasting roles in each cell type within many hormone-related tumors (as stimulator in bladder, kidney and lung metastases vs as suppressor in prostate and liver metastases) may eventually help us to develop better therapeutic approaches by targeting the AR or its downstream signaling in individual cell types to better battle these hormone-related tumors in different stages.
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Affiliation(s)
- C Chang
- 1] George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and the Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA [2] Sex Hormone Research Center, China Medical University/Hospital, Taichung, Taiwan
| | - S O Lee
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and the Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - S Yeh
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and the Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - T M Chang
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and the Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
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22
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Expression of DBC1 and Androgen Receptor Predict Poor Prognosis in Diffuse Large B Cell Lymphoma. Transl Oncol 2013; 6:370-81. [PMID: 23730418 DOI: 10.1593/tlo.13250] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 03/02/2013] [Accepted: 03/20/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Recently, deleted in breast cancer 1 (DBC1) has been suggested as a poor prognostic indicator of various human cancers and may possibly have a role as a coactivator of androgen receptor (AR). However, their roles in lymphoma are still unknown. MATERIALS AND METHODS We investigated the effect of the expression of DBC1 and AR in diffuse large B cell lymphoma (DLBCL). Immunohistochemical expression of DBC1 and AR were evaluated in 101 DLBCL samples by tissue microarray. RESULTS Positive expression of DBC1 and AR was seen in 73% and 70% of DLBCL, respectively. In total DLBCL patients, DBC1 and AR expression were significantly associated with high clinical stage, elevated serum lactate dehydrogenase levels, and high international prognostic index scores, and they predicted shorter overall survival (OS) and relapse-free survival (RFS) by univariate analysis. DBC1 expression was also an independent prognostic indicator by multivariate analysis (OS, P = .017; RFS, P = .004). Especially, both DBC1 and AR expression significantly correlated with shorter OS and RFS in non-germinal center B cell (non-GCB)-type DLBCL by univariate analysis. In multivariate analysis, DBC1 expression was an independent prognostic predictor for OS (P = .035) and AR expression significantly correlated with RFS (P = .005). CONCLUSION We demonstrate that the expression of DBC1 and AR are significant prognostic indicators for DLBCL patients, especially for unfavorable non-GCB-type DLBCL.
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23
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CHEN CHICHENG, HSIEH TENGFU, CHANG CHAOHSIANG, MA WENLUNG, HUNG XIAOFAN, TSAI YIRU, LIN MENGHSUEHAMANDA, ZHANG CAIXIA, CHANG CHAWNSHANG, SHYR CHIHRONG. Androgen receptor promotes the migration and invasion of upper urinary tract urothelial carcinoma cells through the upregulation of MMP-9 and COX-2. Oncol Rep 2013; 30:979-85. [DOI: 10.3892/or.2013.2506] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 03/29/2013] [Indexed: 11/06/2022] Open
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24
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Hsieh TF, Chen CC, Yu AL, Ma WL, Zhang C, Shyr CR, Chang C. Androgen receptor decreases the cytotoxic effects of chemotherapeutic drugs in upper urinary tract urothelial carcinoma cells. Oncol Lett 2013; 5:1325-1330. [PMID: 23599788 PMCID: PMC3629091 DOI: 10.3892/ol.2013.1140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 01/09/2013] [Indexed: 11/06/2022] Open
Abstract
Upper urinary tract urothelial carcinomas (UUTUCs) represent relatively uncommon yet devastating tumors that affect more males than females. However, the correlation between gender difference and disease progression remains unclear. Androgen and the androgen receptor (AR) were previously hypothesized to account for the gender difference in the incidence of urothelial carcinomas; however, the role of AR in the development and progression of UUTUCs is not well understood. In addition, although UUTUCs are responsive to chemotherapy, various responses are presented among patients. Therefore, the aim of the present study was to determine the role of AR in the response of UUTUC cells to chemotherapeutic drugs. In this study, AR overexpression in UUTUC cells (BFTC 909) was identified to reduce the cytotoxic effect of chemotherapeutic drugs, including doxorubicin, cisplatin and mitomycin C and protected cells from drug-induced death. The expression of ABCG2, an ATP-binding cassette half-transporter associated with multidrug resistance, was increased in AR-overexpressing BFTC cells. In addition, use of the AR degradation enhancer, ASC-J9®, repressed the AR effect on increasing cell viability under drug treatment. In summary, results of the present study indicate that the status of AR expression levels in UUTUCs may be a significant factor in affecting the efficacy of chemotherapy and classic chemotherapeutic drugs and AR targeted therapy may provide a novel potential therapeutic approach to improve treatment of UUTUCs.
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Affiliation(s)
- Teng-Fu Hsieh
- Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung 40427
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