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Shao IH, Chang TH, Chang YH, Hsieh YH, Sheng TW, Wang LJ, Chien YH, Huang LK, Chu YC, Kan HC, Lin PH, Yu KJ, Hsieh ML, Chuang CK, Wu CT, Hsieh CH, Pang ST. Periprostatic adipose tissue inhibits tumor progression by secreting apoptotic factors: A natural barrier induced by the immune response during the early stages of prostate cancer. Oncol Lett 2024; 28:485. [PMID: 39170882 PMCID: PMC11338243 DOI: 10.3892/ol.2024.14617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/27/2024] [Indexed: 08/23/2024] Open
Abstract
Prostate cancer (PCa) is the second most prevalent malignancy in men worldwide. The risk factors for PCa include obesity, age and family history. Increased visceral fat has been associated with high PCa risk, which has prompted previous researchers to investigate the influence of body composition and fat distribution on PCa prognosis. However, there is a lack of studies focusing on the mechanisms and interactions between periprostatic adipose tissue (PPAT) and PCa cells. The present study investigated the association between the composition of pelvic adipose tissue and PCa aggressiveness to understand the role played by this tissue in PCa progression. Moreover, PPAT-conditioned medium (CM) was prepared to assess the influence of the PPAT secretome on the pathophysiology of PCa. The present study included 50 patients with localized PCa who received robot-assisted radical prostatectomy. Medical records were collected, magnetic resonance imaging scans were analyzed and body compositions were calculated to identify the associations between adipose tissue volume and clinical PCa aggressiveness. In addition, CM was prepared from PPAT and perivesical adipose tissue (PVAT) collected from 25 patients during surgery, and its effects on the PCa cell lines C4-2 and LNCaP, and the prostate epithelial cell line PZ-HPV-7, were investigated using a cell proliferation assay and RNA sequencing (RNA-seq). The results revealed that the initial prostate-specific antigen level was significantly correlated with pelvic and periprostatic adipose tissue volumes. In addition, PPAT volume was significantly higher in patients with extracapsular tumor extension. PCa cell proliferation was significantly reduced when the cells were cultured in PPAT-CM compared with when they were cultured in control- and PVAT-CM. RNA-seq revealed that immune responses, and the cell death and apoptosis pathways were enriched in PPAT-CM-cultured cells indicating that the cytokines or other factors secreted from PPAT-CM induced PCa cell apoptosis. These findings revealed that the PPAT secretome may inhibit PCa cell proliferation by activating immune responses and promoting cancer cell apoptosis. This mechanism may act as a first-line defense during the early stages of PCa.
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Affiliation(s)
- I-Hung Shao
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Tzu-Hsuan Chang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
| | - Ying-Hsu Chang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
- Division of Urology, Department of Surgery, New Taipei Municipal Tucheng Hospital, New Taipei 236017, Taiwan, R.O.C
| | - Yu-Hsin Hsieh
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
| | - Ting-Wen Sheng
- Department of Medical Imaging and Intervention, New Taipei Municipal Tucheng Hospital, New Taipei 236017, Taiwan, R.O.C
| | - Li-Jen Wang
- Department of Medical Imaging and Intervention, New Taipei Municipal Tucheng Hospital, New Taipei 236017, Taiwan, R.O.C
| | - Yu-Hsuan Chien
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Liang-Kang Huang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Yuan-Cheng Chu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Hung-Cheng Kan
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Po-Hung Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Kai-Jie Yu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Ming-Li Hsieh
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Chun-Te Wu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
| | - Chin-Hsuan Hsieh
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333423, Taiwan, R.O.C
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan, R.O.C
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Jiang S, Li Y, Guo Y, Gong B, Wei C, Liu W, Chen C, Pan F, Song J, He Q, Yang L, Zhou G. MRI-measured periprostatic to subcutaneous adipose tissue thickness ratio as an independent risk factor in prostate cancer patients undergoing radical prostatectomy. Sci Rep 2024; 14:20896. [PMID: 39245685 PMCID: PMC11381511 DOI: 10.1038/s41598-024-71862-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024] Open
Abstract
The purpose of this study is to evaluate whether the periprostatic adipose tissue thickness (PPATT) is an independent prognostic factor for prostate cancer patients after laparoscopic radical prostatectomy (LRP). This retrospective cohort study included consecutive prostate cancer patients who underwent LRP treatment at Wuhan Union Hospital from June 2, 2016, to September 7, 2023. PPATT was defined as the thickness of periprostatic fat and was obtained by measuring the shortest vertical distance from the pubic symphysis to the prostate on the midsagittal T2-weighted MR images. Subcutaneous adipose tissue thickness (SATT) was obtained by measuring the shortest vertical distance from the pubic symphysis to the skin at the same slice with PPATT. The primary outcome of the study was biochemical recurrence (BCR), and the secondary outcome was overall survival (OS). Multivariable Cox regression analysis was used to identify independent prognostic factors for prostate cancer survival and prognosis. Based on the optimal cutoff value, 162 patients were divided into a low PPATT/SATT group (n = 82) and a high PPATT/SATT group (n = 80). During the entire follow-up period (median 23.5 months), 26 patients in the high PPATT/SATT group experienced BCR (32.5%), compared to 18 in the low PPATT/SATT group (22.0%). Kaplan-Meier curve analysis indicated that the interval to BCR was significantly shorter in the high PPATT/SATT group (P = 0.037). Multivariable Cox regression analysis revealed that an increase in the PPATT/SATT ratio was associated with BCR (hazard ratio: 1.90, 95% CI, 1.03-3.51; P = 0.040). The PPATT/SATT ratio is a significant independent risk factor for BCR after LRP for prostate cancer patients.
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Affiliation(s)
- Shanshan Jiang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yi Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yusheng Guo
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Bingxin Gong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chengcheng Wei
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, China
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Weiwei Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chao Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jiyu Song
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qingliu He
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Department of Urology, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, 362000, China.
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Guofeng Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277 Jiefang Avenue, Wuhan, 430022, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Sánchez-Martin S, Altuna-Coy A, Arreaza-Gil V, Bernal-Escoté X, Fontgivell JFG, Ascaso-Til H, Segarra-Tomás J, Ruiz-Plazas X, Chacón MR. Tumoral periprostatic adipose tissue exovesicles-derived miR-20a-5p regulates prostate cancer cell proliferation and inflammation through the RORA gene. J Transl Med 2024; 22:661. [PMID: 39010137 PMCID: PMC11251289 DOI: 10.1186/s12967-024-05458-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/29/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND From the first steps of prostate cancer (PCa) initiation, tumours are in contact with the most-proximal adipose tissue called periprostatic adipose tissue (PPAT). Extracellular vesicles are important carriers of non-coding RNA such as miRNAs that are crucial for cellular communication. The secretion of extracellular vesicles by PPAT may play a key role in the interactions between adipocytes and tumour. Analysing the PPAT exovesicles (EVs) derived-miRNA content can be of great relevance for understanding tumour progression and aggressiveness. METHODS A total of 24 samples of human PPAT and 17 samples of perivesical adipose tissue (PVAT) were used. EVs were characterized by western blot and transmission electron microscopy (TEM), and uptake by PCa cells was verified by confocal microscopy. PPAT and PVAT explants were cultured overnight, EVs were isolated, and miRNA content expression profile was analysed. Pathway and functional enrichment analyses were performed seeking potential miRNA targets. In vitro functional studies were evaluated using PCa cells lines, miRNA inhibitors and target gene silencers. RESULTS Western blot and TEM revealed the characteristics of EVs derived from PPAT (PPAT-EVs) samples. The EVs were up taken and found in the cytoplasm of PCa cells. Nine miRNAs were differentially expressed between PPAT and PVAT samples. The RORA gene (RAR Related Orphan Receptor A) was identified as a common target of 9 miRNA-regulated pathways. In vitro functional analysis revealed that the RORA gene was regulated by PPAT-EVs-derived miRNAs and was found to be implicated in cell proliferation and inflammation. CONCLUSION Tumour periprostatic adipose tissue is linked to PCa tumour aggressiveness and could be envisaged for new therapeutic strategies.
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Affiliation(s)
- Silvia Sánchez-Martin
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
| | - Antonio Altuna-Coy
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
| | - Verónica Arreaza-Gil
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
| | - Xana Bernal-Escoté
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
- Pathology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Joan Francesc Garcia Fontgivell
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
- Pathology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | | | - José Segarra-Tomás
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
- Urology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Xavier Ruiz-Plazas
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
- Urology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Matilde R Chacón
- Disease Biomarkers and Molecular Mechanisms Group. IISPV. Joan, XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain.
- Institut d'Investigació Sanitària Pere Virgili. Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafré Guasch, 4, Tarragona, 43007, Spain.
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Uzun E, Polat ME, Ceviz K, Olcucuoglu E, Tastemur S, Kasap Y, Senel S, Ozdemir O. The importance of periprostatic fat tissue thickness measured by preoperative multiparametric magnetic resonance imaging in upstage prediction after robot-assisted radical prostatectomy. Investig Clin Urol 2024; 65:53-61. [PMID: 38197751 PMCID: PMC10789532 DOI: 10.4111/icu.20230215] [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: 06/26/2023] [Revised: 07/14/2023] [Accepted: 10/16/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE We analyzed the surgical results of patients who were treated and followed up for prostate cancer in our clinic to predict the relationship between periprostatic adipose tissue and patients with and without pathologically upstaged disease. MATERIALS AND METHODS The study included patients who had undergone robot-assisted radical prostatectomy and preoperative multiparametric prostate magnetic resonance imaging between 18 February 2019 and 1 April 2022. The patients were divided into two groups, and the surgical and transrectal ultrasound-guided biopsy pathology results were compared according to tumor grade and distribution in 124 patients who met the selection criteria. We analyzed the relationships between upgrading/upstaging and periprostatic adipose tissue thickness (PPATT) and subcutaneous adipose tissue thickness (SATT) as measured in magnetic resonance imaging. RESULTS The median PPATT was 4.03 mm, whereas the median SATT was 36.4 mm. Upgrading was detected in 45 patients (36.3%), and upstaging was detected in 42 patients (33.9%). A receiver operating characteristic regression analysis revealed that a PPATT >3 mm was a predictive factor for upstaging after radical prostatectomy (area under curve=0.623, 95% confidence interval [CI] 0.519-0.727, p=0.025). Multivariate logistic regression analyses revealed that prostate specific antigen density ≥0.15 ng/mL/cm3 (odds ratio [OR] 5.054, 95% CI 2.008-12.724, p=0.001), International Society of Urological Pathology grade ≥4 (OR 9.369, 95% CI 2.109-21.626, p=0.003) and higher PPATT (OR 1.358, 95% CI 1.081-1.707, p=0.009) were independent risk factors for upstaging after radical prostatectomy. CONCLUSIONS We believe that the PPATT may be a predictive indicator for upstaging after robot-assisted laparoscopic radical prostatectomy.
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Affiliation(s)
- Emre Uzun
- Department of Urology, Ankara City Hospital, Ankara, Türkiye
| | | | - Kazim Ceviz
- Department of Urology, Ankara City Hospital, Ankara, Türkiye
| | | | - Sedat Tastemur
- Department of Urology, Ankara City Hospital, Ankara, Türkiye
| | - Yusuf Kasap
- Department of Urology, Ankara City Hospital, Ankara, Türkiye
| | - Samet Senel
- Department of Urology, Ankara City Hospital, Ankara, Türkiye
| | - Ozkan Ozdemir
- Department of Radiology, Ankara City Hospital, Ankara, Türkiye
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Xiong T, Cao F, Zhu G, Ye X, Cui Y, Zhang H, Niu Y. MRI-measured adipose features as predictive factors for detection of prostate cancer in males undergoing systematic prostate biopsy: a retrospective study based on a Chinese population. Adipocyte 2022; 11:653-664. [PMID: 36415995 PMCID: PMC9704414 DOI: 10.1080/21623945.2022.2148885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In this study, we retrospectively evaluated the data of 901 men undergoing ultrasonography-guided systematic prostate biopsy between March 2013 and May 2022. Adipose features, including periprostatic adipose tissue (PPAT) thickness and subcutaneous fat thickness, were measured using MRI before biopsy. Prediction models of all PCa and clinically significant PCa (csPCa) (Gleason score higher than 6) were established based on variables selected by multivariate logistic regression and prediction nomograms were constructed. Patients with PCa had higher PPAT thickness (4.64 [3.65-5.86] vs. 3.54 [2.49-4.51] mm, p < 0.001) and subcutaneous fat thickness (29.19 [23.05-35.95] vs. 27.90 [21.43-33.93] mm, p = 0.013) than those without PCa. Patients with csPCa had higher PPAT thickness (4.78 [3.80-5.88] vs. 4.52 [3.80-5.63] mm, p = 0.041) than those with non-csPCa. Adding adipose features to the prediction models significantly increased the area under the receiver operating characteristics curve for the prediction of all PCa (0.850 vs. 0.819, p < 0.001) and csPCa (0.827 vs. 0.798, p < 0.001). Based on MRI-measured adipose features and clinical parameters, we established two nomograms that were simple to use and could improve patient selection for prostate biopsy in Chinese population.
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Affiliation(s)
- Tianyu Xiong
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Fang Cao
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Guangyi Zhu
- Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xiaobo Ye
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yun Cui
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Huibo Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,Huibo Zhang Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, China
| | - Yinong Niu
- Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China,CONTACT Yinong Niu Department of Urology, Beijing Shijitan Hospital, Capital Medical University, 10 Tieyiyuan Road, Haidian District, Beijing, China
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Feng S, Lou K, Luo C, Zou J, Zou X, Zhang G. Obesity-Related Cross-Talk between Prostate Cancer and Peripheral Fat: Potential Role of Exosomes. Cancers (Basel) 2022; 14:5077. [PMID: 36291860 PMCID: PMC9600017 DOI: 10.3390/cancers14205077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
Abstract
The molecular mechanisms of obesity-induced cancer progression have been extensively explored because of the significant increase in obesity and obesity-related diseases worldwide. Studies have shown that obesity is associated with certain features of prostate cancer. In particular, bioactive factors released from periprostatic adipose tissues mediate the bidirectional communication between periprostatic adipose tissue and prostate cancer. Moreover, recent studies have shown that extracellular vesicles have a role in the relationship between tumor peripheral adipose tissue and cancer progression. Therefore, it is necessary to investigate the feedback mechanisms between prostate cancer and periglandular adipose and the role of exosomes as mediators of signal exchange to understand obesity as a risk factor for prostate cancer. This review summarizes the two-way communication between prostate cancer and periglandular adipose and discusses the potential role of exosomes as a cross-talk and the prospect of using adipose tissue as a means to obtain exosomes in vitro. Therefore, this review may provide new directions for the treatment of obesity to suppress prostate cancer.
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Affiliation(s)
- Shangzhi Feng
- The First Clinical College, Gannan Medical University, Ganzhou 341000, China
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Kecheng Lou
- The First Clinical College, Gannan Medical University, Ganzhou 341000, China
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Cong Luo
- The First Clinical College, Gannan Medical University, Ganzhou 341000, China
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Junrong Zou
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
- Institute of Urology, The First Affiliated Hospital of Ganna Medical University, Ganzhou 341000, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou 341000, China
| | - Xiaofeng Zou
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
- Institute of Urology, The First Affiliated Hospital of Ganna Medical University, Ganzhou 341000, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou 341000, China
| | - Guoxi Zhang
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
- Institute of Urology, The First Affiliated Hospital of Ganna Medical University, Ganzhou 341000, China
- Jiangxi Engineering Technology Research Center of Calculi Prevention, Ganzhou 341000, China
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Chien YH, Hsieh ML, Sheng TW, Chang YH, Wang LJ, Chuang CK, Pang ST, Wu CT, Shao IH. Body composition and pelvic fat distribution are associated with prostate cancer aggressiveness and can predict biochemical recurrence. Medicine (Baltimore) 2022; 101:e31076. [PMID: 36221433 PMCID: PMC9542672 DOI: 10.1097/md.0000000000031076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study evaluated the effect of body composition and pelvic fat distribution on the aggressiveness and prognosis of localized prostate cancer. This study included patients who underwent robot-assisted radical prostatectomy with positive surgical margins. Clinicodemographic data were collected from patients' medical reports. Pretreatment magnetic resonance images (MRI) obtained for cancer staging were reviewed by a single radiologist to calculate pelvic fat distribution and body composition. We correlated these body composition parameters with initial prostate-specific antigen (iPSA), Gleason score, extracapsular tumor extension, and biochemical recurrence (BCR)-free survival. The iPSA was significantly associated with body mass index (BMI; P = .027), pelvic fat volume (P = .004), and perirectal fat volume (P = .001), whereas the Gleason score was significantly associated with BMI only (P = .011). Tumor extracapsular extension was significantly associated with increased periprostatic fat volume (P = .047). Patients with less subcutaneous fat thickness (<2.4 cm) had significantly poor BCR-free survival (P = .039). Pelvic fat distribution, including pelvic fat volume, perirectal fat volume, and periprostatic fat volume, were significantly correlated with prostate cancer aggressiveness. Patients with less subcutaneous fat had an increased risk of BCR after radical prostatectomy.
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Affiliation(s)
- Yu-Hsuan Chien
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Li Hsieh
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Wen Sheng
- Department of Medical Imaging and Intervention, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ying-Hsu Chang
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Wang
- Department of Medical Imaging and Intervention, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Te Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelong Branch, Taiwan
| | - I-Hung Shao
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Cancer Genome Research Center, Chang Gung Memorial Hospital
- *Correspondence: I-Hung Shao, Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, 5, Fushing Street, Kweishan, Taoyuan, Taiwan (e-mail: )
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Combined miR-486 and GP88 (Progranulin) Serum Levels Are Suggested as Supportive Biomarkers for Therapy Decision in Elderly Prostate Cancer Patients. Life (Basel) 2022; 12:life12050732. [PMID: 35629399 PMCID: PMC9143270 DOI: 10.3390/life12050732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022] Open
Abstract
Our study aimed to assess the applicability of miR-486 in combination with soluble GP88 protein as a diagnostic and/or predictive biomarker for prostate cancer (PCa) patients. miR-486 and GP88 levels in serum samples from 136 patients undergoing MRI-guided biopsy of the prostate were assessed by qRT−PCR and ELISA, respectively. Of these, 86 patients received a histologically confirmed diagnosis of PCa. Neither marker showed an association with the diagnosis of cancer. PCa patients were separated based on (i) treatment into patients with active surveillance or patients with any type of curative treatment and (ii) age into elderly (>68 years) patients and younger patients (≤68 years). In elderly patients (N = 41) with the intention of curative treatment at optimized cut-off values, significantly higher GP88 levels (p = 0.018) and lower miR-486 levels (p = 0.014) were observed. The total PSA level and ISUP biopsy grade were used in a baseline model for predicting definitive therapy. The baseline model exhibited an area under the curve (AUC) of 0.783 (p = 0.005). The addition of the serum biomarkers miR-486 and GP88 to the baseline model yielded an improved model with an AUC of 0.808 (p = 0.002). Altogether, combined miR-486 and GP88 serum levels are associated with and are therefore suggested as supportive biomarkers for therapy decisions, particularly in elderly PCa patients.
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9
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Thromboinflammatory Processes at the Nexus of Metabolic Dysfunction and Prostate Cancer: The Emerging Role of Periprostatic Adipose Tissue. Cancers (Basel) 2022; 14:cancers14071679. [PMID: 35406450 PMCID: PMC8996963 DOI: 10.3390/cancers14071679] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary As overweight and obesity increase among the population worldwide, a parallel increase in the number of individuals diagnosed with prostate cancer was observed. There appears to be a relationship between both diseases where the increase in the mass of fat tissue can lead to inflammation. Such a state of inflammation could produce many factors that increase the aggressiveness of prostate cancer, especially if this inflammation occurred in the fat stores adjacent to the prostate. Another important observation that links obesity, fat tissue inflammation, and prostate cancer is the increased production of blood clotting factors. In this article, we attempt to explain the role of these latter factors in the effect of increased body weight on the progression of prostate cancer and propose new ways of treatment that act by affecting how these clotting factors work. Abstract The increased global prevalence of metabolic disorders including obesity, insulin resistance, metabolic syndrome and diabetes is mirrored by an increased incidence of prostate cancer (PCa). Ample evidence suggests that these metabolic disorders, being characterized by adipose tissue (AT) expansion and inflammation, not only present as risk factors for the development of PCa, but also drive its increased aggressiveness, enhanced progression, and metastasis. Despite the emerging molecular mechanisms linking AT dysfunction to the various hallmarks of PCa, thromboinflammatory processes implicated in the crosstalk between these diseases have not been thoroughly investigated. This is of particular importance as both diseases present states of hypercoagulability. Accumulating evidence implicates tissue factor, thrombin, and active factor X as well as other players of the coagulation cascade in the pathophysiological processes driving cancer development and progression. In this regard, it becomes pivotal to elucidate the thromboinflammatory processes occurring in the periprostatic adipose tissue (PPAT), a fundamental microenvironmental niche of the prostate. Here, we highlight key findings linking thromboinflammation and the pleiotropic effects of coagulation factors and their inhibitors in metabolic diseases, PCa, and their crosstalk. We also propose several novel therapeutic targets and therapeutic interventions possibly modulating the interaction between these pathological states.
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10
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The volume and thickness of preprostatic fat on MRIs are not associated with prostate cancer aggressiveness in men undergoing radical prostatectomy. Prog Urol 2022; 32:341-353. [DOI: 10.1016/j.purol.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/22/2022]
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11
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Fidelito G, Watt MJ, Taylor RA. Personalized Medicine for Prostate Cancer: Is Targeting Metabolism a Reality? Front Oncol 2022; 11:778761. [PMID: 35127483 PMCID: PMC8813754 DOI: 10.3389/fonc.2021.778761] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023] Open
Abstract
Prostate cancer invokes major shifts in gene transcription and metabolic signaling to mediate alterations in nutrient acquisition and metabolic substrate selection when compared to normal tissues. Exploiting such metabolic reprogramming is proposed to enable the development of targeted therapies for prostate cancer, yet there are several challenges to overcome before this becomes a reality. Herein, we outline the role of several nutrients known to contribute to prostate tumorigenesis, including fatty acids, glucose, lactate and glutamine, and discuss the major factors contributing to variability in prostate cancer metabolism, including cellular heterogeneity, genetic drivers and mutations, as well as complexity in the tumor microenvironment. The review draws from original studies employing immortalized prostate cancer cells, as well as more complex experimental models, including animals and humans, that more accurately reflect the complexity of the in vivo tumor microenvironment. In synthesizing this information, we consider the feasibility and potential limitations of implementing metabolic therapies for prostate cancer management.
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Affiliation(s)
- Gio Fidelito
- Department of Anatomy & Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew J. Watt
- Department of Anatomy & Physiology, The University of Melbourne, Melbourne, VIC, Australia
- *Correspondence: Renea A. Taylor, ; Matthew J. Watt,
| | - Renea A. Taylor
- Department of Physiology, Biomedicine Discovery Institute, Cancer Program, Monash University, Melbourne, VIC, Australia
- Prostate Cancer Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
- *Correspondence: Renea A. Taylor, ; Matthew J. Watt,
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12
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Fatty Acid Metabolism Reprogramming in Advanced Prostate Cancer. Metabolites 2021; 11:metabo11110765. [PMID: 34822423 PMCID: PMC8618281 DOI: 10.3390/metabo11110765] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer (PCa) is a carcinoma in which fatty acids are abundant. Fatty acid metabolism is rewired during PCa development. Although PCa can be treated with hormone therapy, after prolonged treatment, castration-resistant prostate cancer can develop and can lead to increased mortality. Changes to fatty acid metabolism occur systemically and locally in prostate cancer patients, and understanding these changes may lead to individualized treatments, especially in advanced, castration-resistant prostate cancers. The fatty acid metabolic changes are not merely reflective of oncogenic activity, but in many cases, these represent a critical factor in cancer initiation and development. In this review, we analyzed the literature regarding systemic changes to fatty acid metabolism in PCa patients and how these changes relate to obesity, diet, circulating metabolites, and peri-prostatic adipose tissue. We also analyzed cellular fatty acid metabolism in prostate cancer, including fatty acid uptake, de novo lipogenesis, fatty acid elongation, and oxidation. This review broadens our view of fatty acid switches in PCa and presents potential candidates for PCa treatment and diagnosis.
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13
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Ferro M, Terracciano D, Musi G, de Cobelli O, Vartolomei MD, Damiano R, Cantiello F, Buonerba C, Morelli M, Mistretta FA, Luzzago S, Perdonà S, Del Prete P, Del Giudice F, Busetto GM, Porreca A, Autorino R, Manfredi M, Porpiglia F, Muto M, Loizzo D, Ditonno P, Battaglia M, Lucarelli G. Increased Body Mass Index Is a Risk Factor for Poor Clinical Outcomes after Radical Prostatectomy in Men with International Society of Urological Pathology Grade Group 1 Prostate Cancer Diagnosed with Systematic Biopsies. Urol Int 2021; 106:75-82. [PMID: 34167120 DOI: 10.1159/000516680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The association between obesity and clinically significant prostate cancer (PCa) is still a matter of debate. In this study, we evaluated the effect of body mass index (BMI) on the prediction of pathological unfavorable disease (UD), positive surgical margins (PSMs), and biochemical recurrence (BCR) in patients with clinically localized (≤cT2c) International Society of Urological Pathology (ISUP) grade group 1 PCa at biopsy. METHODS 427 patients with ISUP grade group 1 PCa who have undergone radical prostatectomy and BMI evaluation were included. The outcome of interest was the presence of UD (defined as ISUP grade group ≥3 and pT ≥3a), PSM, and BCR. RESULTS Statistically significant differences resulted in comparing BMI with prostate-specific antigen (PSA) and serum testosterone levels (both p < 0.0001). Patients with UD and PSM had higher BMI values (p < 0.0001 and p = 0.006, respectively). BCR-free survival was significantly decreased in patients with higher BMI values (p < 0.0001). BMI was an independent risk factor for BCR and PSM. Receiver-operating characteristic analysis testing PSA accuracy in different BMI groups, showed that PSA had a reduced predictive value (area under the curve [AUC] = 0.535; 95% confidence interval [CI] = 0.422-0.646), in obese men compared to overweight (AUC = 0.664; 95% CI = 0.598-0.725) and normal weight patients (AUC = 0.721; 95% CI = 0.660-0.777). CONCLUSION Our findings show that increased BMI is a significant predictor of UD and PSM at RP in patients with preoperative low-to intermediate-risk diseases, suggesting that BMI evaluation may be useful in a clinical setting to identify patients with favorable preoperative disease characteristics harboring high-risk PCa.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gennaro Musi
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ottavio de Cobelli
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Mihai Dorin Vartolomei
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.,Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Carlo Buonerba
- Department of Oncology and Hematology, Regional Reference Center for Rare Tumors, AOU Federico II of Naples, Naples, Italy
| | - Michele Morelli
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | | | - Stefano Luzzago
- Division of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Sisto Perdonà
- Division of Urology, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Paola Del Prete
- Scientific Directorate, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | | | | | - Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | | | - Matteo Manfredi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Turin, Italy
| | - Matteo Muto
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Davide Loizzo
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
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14
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Zhai TS, Hu LT, Ma WG, Chen X, Luo M, Jin L, Zhou Z, Liu X, Kang Y, Kang YX, Zhang JX, Liu H, Lu JY, Yao XD, Ye L. Peri-prostatic adipose tissue measurements using MRI predict prostate cancer aggressiveness in men undergoing radical prostatectomy. J Endocrinol Invest 2021; 44:287-296. [PMID: 32474764 DOI: 10.1007/s40618-020-01294-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/07/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To evaluate the effect of peri-prostatic adipose tissue (PPAT) measurements using preoperative MRI on the prediction of prostate cancer (PCa) aggressiveness in men undergoing radical prostatectomy (RP). METHODS We performed a retrospective study on 179 consecutive patients receiving RP from June 2016 to October 2018. Clinical characteristics were collected. PPAT measurements including peri-prostatic fat area (PPFA) and peri-prostatic fat area to prostate area (PA) ratio (PPFA/PA) were calculated by MRI. Multivariable logistic regression analysis was performed to identify independent predictors of PCa lymph node metastasis (LNM). The predictive performance was estimated through ROC curves. Nomograms were created based on the predictors. RESULTS Pathologic Gleason score positively correlated with digital rectal examination (DRE), PSA, PPFA/PA, P504S, and Ki-67 (all P < 0.05). ROC curves revealed that high PPFA and high PPFA/PA were associated with LNM (both P < 0.05). Multivariate analysis revealed that high PPFA/PA, pathologic Gleason score, pT stage, and Ki-67 were independently predictive of LNM. The nomograms were created and the C-index was 0.945. CONCLUSIONS PPFA/PA is an independent predictor for LNM along with Gleason score, pT stage, and Ki-67. PPFA/PA may help predict LNM in men undergoing RP, thus providing adjunctive information for therapeutic strategy and prognosis.
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Affiliation(s)
- T -S Zhai
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - L -T Hu
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
| | - W -G Ma
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
- Department of Urology, Tongxin People's Hospital, Tongxin, 751300, Ningxia, China
| | - X Chen
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China
| | - M Luo
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - L Jin
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - Z Zhou
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
- Department of Urology, First Clinical Medical College, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - X Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
- Department of Urology, Shanghai Putuo District People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China
| | - Y Kang
- The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - Y -X Kang
- The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - J -X Zhang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - H Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China
| | - J -Y Lu
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China.
| | - X -D Yao
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China.
| | - L Ye
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China.
- Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China.
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15
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Iemura Y, Hori S, Tatsumi Y, Fukui S, Miyake M, Matsumura Y, Kagebayashi Y, Samma S, Fujimoto K. Periprostatic fat thickness quantified by preoperative magnetic resonance imaging is an independent risk factor for upstaging from cT1/2 to pT3 in robot-assisted radical prostatectomy. Int J Urol 2020; 27:1144-1149. [PMID: 32969085 DOI: 10.1111/iju.14376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/18/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To analyze the correlation between periprostatic fat thickness on multiparametric magnetic resonance imaging and upstaging from cT1/2 to pT3 in robot-assisted radical prostatectomy. METHODS We retrospectively evaluated data from men with cT1/2 prostate cancer treated with robot-assisted radical prostatectomy at Nara Prefecture General Medical Center, Nara, Japan, between March 2013 and December 2017. We calculated the periprostatic fat thickness and subcutaneous thickness from preoperative multiparametric magnetic resonance imaging. We divided the cohort into two groups for analysis. Group 1 included patients upstaged from clinical to pathological stage, whereas group 2 included those without upstaging. RESULTS Data on 220 patients meeting the inclusion criteria were included in the analysis. A total of 36 patients were upstaged from clinical T1 or T2 to pathological T3, whereas 184 patients were not upstaged. The upstaging was associated with prostate volume, Gleason score, prostate-specific antigen density, periprostatic fat thickness, Prostate Imaging Reporting and Data System score based on univariate analysis. Multivariate analysis showed prostate volume (P = 0.03, odds ratio 0.958, 95% confidence interval 0.921-0.996), Gleason score (P = 0.022, odds ratio 2.676, 95% confidence interval 1.153-6.213) and periprostatic fat thickness (P = 0.004, odds ratio 1.26, 95% confidence interval 1.079-1.471) as independent risk factors of upstaging. CONCLUSIONS Prostate volume, Gleason score and periprostatic fat thickness on multiparametric magnetic resonance imaging are significantly associated with and independent risk factors for upstaging from cT1/2 to pT3 in patients undergoing robot-assisted radical prostatectomy.
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Affiliation(s)
- Yusuke Iemura
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan.,Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshihiro Tatsumi
- Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Shinji Fukui
- Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshiaki Matsumura
- Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Yoriaki Kagebayashi
- Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Shoji Samma
- Department of Urology, Nara Prefecture General Medical Center, Nara City, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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16
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Bhardwaj P, Ikeda T, Zhou XK, Wang H, Zheng XE, Giri DD, Elemento O, Verma A, Miyazawa M, Mukherjee S, Falcone DJ, Wendel NK, Scherr DS, Dannenberg AJ. Supplemental estrogen and caloric restriction reduce obesity-induced periprostatic white adipose inflammation in mice. Carcinogenesis 2020; 40:914-923. [PMID: 31067318 DOI: 10.1093/carcin/bgz088] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/13/2019] [Accepted: 05/07/2019] [Indexed: 01/22/2023] Open
Abstract
Obesity is associated with an increased incidence of high-grade prostate cancer (PC) and worse prognosis for PC patients. Recently, we showed in men that obesity-related periprostatic white adipose tissue (WAT) inflammation, characterized by macrophages surrounding dead or dying adipocytes forming crown-like structures, was associated with high-grade PC. Possibly, interventions that suppress periprostatic WAT inflammation will improve outcomes for men with PC. Here, we tested the hypothesis that supplemental 17β-estradiol (E2) could decrease periprostatic WAT inflammation in obese male mice. Mice were fed a high-fat diet to induce periprostatic WAT inflammation before being treated with supplemental E2. E2 supplementation suppressed caloric intake, induced weight loss, decreased periprostatic WAT inflammation and downregulated the expression of genes linked to inflammation including Cd68, Mcp1 and Tnf. Similar to the effects of E2 supplementation, treatment with diethylstilbestrol, a synthetic estrogen, also suppressed caloric intake and reduced periprostatic WAT inflammation. To determine whether the observed effects of supplemental estrogen could be reproduced by caloric restriction (CR) alone, obese mice were put on a 30% CR diet. Like estrogen treatment, CR was effective in reducing body weight, periprostatic WAT inflammation and the expression of pro-inflammatory genes. Transcriptomic analyses of periprostatic fat showed that obesity was associated with enrichment in inflammatory response pathways, which were normalized by both supplemental E2 and CR. Taken together, these findings strengthen the rationale for future efforts to determine whether either CR or supplemental estrogen will decrease periprostatic WAT inflammation and thereby improve outcomes for men with PC.
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Affiliation(s)
- Priya Bhardwaj
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Takahiro Ikeda
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Xi Kathy Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - Xi Emily Zheng
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olivier Elemento
- Departments of Physiology and Biophysics, Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine
| | - Akanksha Verma
- Departments of Physiology and Biophysics, Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine
| | - Miki Miyazawa
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Domenick J Falcone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Nils K Wendel
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Douglas S Scherr
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
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17
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Zhai TS, Jin L, Hu LT, Kadier A, Zhou Z, Liu X, Liu H, Li S, Lu JY, Yao XD, Ye L. Impact of peri-prostatic fat measurements using MRI on the prediction of prostate cancer with transrectal ultrasound-guided biopsy. Urol Oncol 2019; 38:37.e1-37.e9. [PMID: 31812632 DOI: 10.1016/j.urolonc.2019.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/20/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To estimate the impact of peri-prostatic fat (PPF) measurements using preoperative magnetic resonance imaging on the prediction of prostate cancer (PCa) with transrectal ultrasound-guided biopsy. PATIENTS AND METHODS We performed a retrospective 2-center study on 660 consecutive patients receiving transrectal ultrasound-guided biopsy-biopsy from June 2016 to October 2018. Pathologic and immunohistochemical characteristics were collected. PPF measurements including PPF area (PPFA) and PPFA to prostate area (PA) ratio (PPFA/PA) were assessed by preoperative staging magnetic resonance imaging. Clinical variables were correlated with Gleason score by using Spearman (ρ) correlation coefficients. Multivariable analysis was performed to identify independent predictors of PCa. The diagnostic performance was estimated using ROC curves. RESULTS The Gleason score was significantly correlated with age (ρ = 0.114, P = 0.035), prostate-specific antigen (PSA) (ρ = 0.482, P < 0.001), PIRADS scoring (ρ = 0.403, P < 0.001) and PPFA/PA (ρ = 0.238, P < 0.001). Multivariate analysis revealed that PPFA/PA, age, digital rectal examination, family history of PCa, PSA, and PIRADS scoring were independently predictive of PCa. The ROC AUC to detect PCa or clinically significant PCa (CS-PCa; Gleason Score 3 + 4 or greater) improved with the addition of PPFA/PA (PCa: 0.93 vs. 0.89; CS-PCa: 0.92 vs. 0.90). CONCLUSION PPFA/PA is an independent predictor for PCa along with age, digital rectal examination, family history of PCa, PSA, and PIRADS scoring. PPF measurements especially PPFA/PA may help detect PCa or CS-PCa, thus helping improve PCa risk stratification and screening to avoid unnecessary biopsies.
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Affiliation(s)
- Ting-Shuai Zhai
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Liang Jin
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Lan-Ting Hu
- Department of Urology, Karamay Central Hospital, Karamay, Xinjiang, China
| | - Aimaitiaji Kadier
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Zhen Zhou
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China; Nanjing Medical University, Nanjing, China
| | - Xiang Liu
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Huan Liu
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Sheng Li
- Department of Biochemistry, Dalian Medical University, Dalian, China
| | - Jing-Yi Lu
- Department of Urology, Karamay Central Hospital, Karamay, Xinjiang, China
| | - Xu-Dong Yao
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China.
| | - Lin Ye
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China; Department of Urology, Karamay Central Hospital, Karamay, Xinjiang, China.
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18
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Pre-treatment ratio of periprostatic to subcutaneous fat thickness on MRI is an independent survival predictor in hormone-naïve men with advanced prostate cancer. Int J Clin Oncol 2019; 25:370-376. [PMID: 31617025 DOI: 10.1007/s10147-019-01559-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/01/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidemiological studies have shown an association between obesity and prostate cancer (PCa) aggressiveness. However, little is known about periprostatic fat (PPF) and its relationship with overall fat deposition in PCa. PPF is thought to contribute to PCa growth and migration via secreted factors and induction of chronic inflammation. We investigated if pre-treatment PPF thickness correlates with overall survival (OS). METHODS We reviewed 85 hormone-naïve men with advanced PCa who had received androgen deprivation therapy (ADT). PPF thickness was measured by magnetic resonance imaging (MRI) and compared with subcutaneous fat (SCF) thickness as an internal control. Visceral fat (VF) area measured by computed tomography served as an additional control. We evaluated the relationship between laboratory data, pathology results, and obesity parameters and OS. RESULTS Median follow-up was 50.6 months. Thirty-six patients died during follow-up. Univariate analysis revealed that nadir PSA titer, Gleason score, N stage, M stage, extent of disease by bone scan grade, hemoglobin, lactate dehydrogenase, alkaline phosphatase, and PPF/SCF ratio were associated with OS. Multivariate analysis revealed that nadir PSA titer, N stage, and PPF/SCF ratio were independent prognostic factors for survival. The 5-year OS in the patients with higher PPF/SCF ratio (≥ 1) and lower PPF/SCF ratio (< 1) was 49.5% and 66.5%, respectively (P = 0.039). CONCLUSIONS Pre-treatment ratio of PPF-to-SCF thickness on MRI is an independent predictor of survival in hormone-naïve men with advanced PCa. This could be useful for predicting which patients are more likely to develop castration-resistant PCa.
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Huang H, Chen S, Li W, Bai P, Wu X, Xing J. Periprostatic Fat Thickness on MRI is an Independent Predictor of Time to Castration-resistant Prostate Cancer in Chinese Patients With Newly Diagnosed Prostate Cancer Treated With Androgen Deprivation Therapy. Clin Genitourin Cancer 2019; 17:e1036-e1047. [PMID: 31281063 DOI: 10.1016/j.clgc.2019.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/28/2019] [Accepted: 06/03/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the association between periprostatic fat thickness (PPFT) and time to castration-resistant prostate cancer (CRPC) in newly diagnosed patients with prostate cancer (PCa) treated with androgen deprivation therapy (ADT). PATIENTS AND METHODS We retrospectively reviewed the medical records of 150 patients with PCa treated with ADT at our hospital between June 2011 and June 2017. PPFT measured on magnetic resonance imaging (MRI) and PPFT/periprostatic fat volume (PPFV) measured on computed tomography (CT) were evaluated. Kaplan-Meier curves and log-rank tests were used to assess significant differences in time to CRPC between the 2 groups (high PPFT vs. low PPFT, determined by PPFT > or < the median value, respectively). Univariable and multivariable Cox regression analyses were employed to identify the potential prognostic factors for survival. RESULTS The median value of PPFT measured on MRI was 0.555 cm. PPFT was significantly associated with PPFV measured on CT images (with a correlation coefficient of 0.825; P < .001). A total of 66 patients (44%) progressed to CRPC during the follow-up period. Patients with high PPFT (measured on MRI) showed a significantly shorter PFS than patients with low PPFT. Multivariable Cox analysis demonstrated that T stage, presence of distant metastasis, shorter time to prostate-specific antigen nadir, higher prostate-specific antigen nadir, Gleason score (greater than 4 + 4), and high PPFT were significantly associated with shorter PFS. CONCLUSIONS PPFT is significantly associated with PPFV measured on CT images. PPFT measured on MRI is a readily available and significant predictor of time to CRPC in patients with PCa receiving ADT as the primary treatment.
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Affiliation(s)
- Haichao Huang
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Shi Chen
- Department of Radiology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Wei Li
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Peide Bai
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Xiurong Wu
- Department of Radiology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Jinchun Xing
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China.
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Lucarelli G, Loizzo D, Ferro M, Rutigliano M, Vartolomei MD, Cantiello F, Buonerba C, Di Lorenzo G, Terracciano D, De Cobelli O, Bettocchi C, Ditonno P, Battaglia M. Metabolomic profiling for the identification of novel diagnostic markers and therapeutic targets in prostate cancer: an update. Expert Rev Mol Diagn 2019; 19:377-387. [PMID: 30957583 DOI: 10.1080/14737159.2019.1604223] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION An altered metabolic regulation is involved in the development and progression of different cancer types. As well as this, many genes associated with tumors are shown to have an important role in control of the metabolism. The incidence of prostate cancer (PCa) is increased in men with metabolic disorders. In particular, obesity is an established risk factor for PCa. An increased body mass index correlates with aggressive disease, and a higher risk of biochemical recurrence and prostate cancer-specific mortality. Increased lipogenesis is also one of the most significant events in PCa metabolism reprogramming. Areas covered: In this article, we provide an updated review of the current understanding of the PCa metabolome and evaluate the possibility of unveiling novel therapeutic targets. Expert opinion: Obesity is an established risk factor for PCa, and an increased BMI correlates with aggressive disease, and a higher risk of biochemical recurrence and prostate cancer-specific mortality. PCa metabolome is characterized by the accumulation of metabolic intermediates and an increased expression of genes in the tricarboxylic acid cycle, the induction of de novo lipogenesis and cholesterogenesis. PCa cells can induce different alterations in their microenvironment by modulating the crosstalk between cancer and stromal cells.
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Affiliation(s)
- Giuseppe Lucarelli
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
| | - Davide Loizzo
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
| | - Matteo Ferro
- b Division of Urology , European Institute of Oncology , Milan , Italy
| | - Monica Rutigliano
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
| | - Mihai Dorin Vartolomei
- c Department of Cell and Molecular Biology , University of Medicine and Pharmacy , Tirgu Mures , Romania
| | - Francesco Cantiello
- d Department of Urology , Magna Graecia University of Catanzaro , Catanzaro , Italy
| | - Carlo Buonerba
- e Medical Oncology Division, Department of Clinical Medicine and Surgery , University Federico II of Naples , Naples , Italy
| | - Giuseppe Di Lorenzo
- e Medical Oncology Division, Department of Clinical Medicine and Surgery , University Federico II of Naples , Naples , Italy
| | - Daniela Terracciano
- f Department of Translational Medical Sciences , University of Naples "Federico II" , Naples , Italy
| | | | - Carlo Bettocchi
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
| | - Pasquale Ditonno
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
| | - Michele Battaglia
- a Department of Emergency and Organ Transplantation - Urology, Andrology and Kidney Transplantation Unit , University of Bari , Bari , Italy
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Dahran N, Szewczyk-Bieda M, Vinnicombe S, Fleming S, Nabi G. Periprostatic fat adipokine expression is correlated with prostate cancer aggressiveness in men undergoing radical prostatectomy for clinically localized disease. BJU Int 2019; 123:985-994. [PMID: 29969844 DOI: 10.1111/bju.14469] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the relationship between periprostatic adipose tissue (PPAT) adipokine expression and prostate cancer (PCa) aggressiveness using both pathological features of radical prostatectomy (RP) and multiparametric magnetic resonance imaging ( MRI) variables. PATIENTS AND METHODS Sixty-nine men were recruited to assess immunohistochemical expression of tumour necrosis factor (TNF)α and vascular endothelial growth factor (VEGF) of periprostatic fat of RP specimens. Per cent immunopositivity was quantified on scanned slides using the Aperio Positive Pixel Count algorithm for PPAT TNFα, VEGF and androgen receptors. Periprostatic fat volume (PFV) was segmented on contiguous T1 -weighted axial MRI slices from the level of the prostate base to apex. PFV was normalized to prostate volume (PV) to account for variations in PV (normalized PFV = PFV/PV). MRI quantitative values (Kep , Ktrans and apparent diffusion coefficient) were measured from the PCa primary lesion using Olea Sphere software. Patients were stratified into three groups according to RP Gleason score (GS): ≤6, 7(3 + 4) and ≥7(4 + 3). RESULTS The mean rank of VEGF and TNFα was significantly different between the groups [H(2) = 11.038, P = 0.004] and [H(2) = 13.086, P = 0.001], respectively. Patients with stage pT3 had higher TNFα (18.2 ± 8.95) positivity than patients with stage pT2 (13.27 ± 10.66; t [67] = -2.03, P = 0.047). TNFα expression significantly correlated with Ktrans (ρ = 0.327, P = 0.023). TNFα (P = 0.043), and VEGF (P = 0.02) correlated with high grade PCa (GS ≥ 7) in RP specimens and also correlated significantly with upgrading of GS from biopsy to RP histology. CONCLUSIONS The expression levels of TNFα and VEGF on immunostaining significantly correlated with aggressivity of PCa. As biomarkers, these indicate the risk of having high grade PCa in men undergoing RP.
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Affiliation(s)
- Naief Dahran
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK.,Department of Anatomy, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | - Sarah Vinnicombe
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
| | - Stewart Fleming
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
| | - Ghulam Nabi
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
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Galbraith L, Leung HY, Ahmad I. Lipid pathway deregulation in advanced prostate cancer. Pharmacol Res 2018; 131:177-184. [PMID: 29466694 DOI: 10.1016/j.phrs.2018.02.022] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/08/2018] [Accepted: 02/14/2018] [Indexed: 01/03/2023]
Abstract
The link between prostate cancer (PC) development and lipid metabolism is well established, with AR intimately involved in a number of lipogenic processes involving SREBP1, PPARG, FASN, ACC, ACLY and SCD1. Recently, there is growing evidence implicating the role of obesity and peri-prostatic adipose tissue (PPAT) in PC aggressiveness and related mortality, suggesting the importance of lipid pathways in both localised and disseminated disease. A number of promising agents are in development to target the lipogenic axis in PC, and the likelihood is that these agents will form part of combination drug strategies, with targeting of multiple metabolic pathways (e.g. FASN and CPT1), or in combination with AR pathway inhibitors (SCD1 and AR).
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Affiliation(s)
- Laura Galbraith
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - Hing Y Leung
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - Imran Ahmad
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK.
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23
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The combination of prostate imaging reporting and data system version 2 (PI-RADS v2) and periprostatic fat thickness on multi-parametric MRI to predict the presence of prostate cancer. Oncotarget 2018; 8:44040-44049. [PMID: 28476042 PMCID: PMC5546460 DOI: 10.18632/oncotarget.17182] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/27/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To evaluate the auxiliary effectiveness of periprostatic fat thickness (PPFT) on multi-parametric magnetic resonance imaging (mp-MRI) to Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) in predicting the presence of prostate cancer (PCa) and high-grade prostate cancer (HGPCa, Gleason Score ≥ 7). RESULTS Overall, there were 371 patients (54.3%) with PCa and 292 patients (42.8%) with HGPCa. The mean value of PPFT was 4.04 mm. Multivariate analysis revealed that age, prostatic specific antigen (PSA), volume, PI-RADS score, and PPFT were independent predictors of PCa. All factors plus abnormal digital rectal exam were independent predictors of HGPCa. In addition, the PPFT was the independent predictor of PCa (Odds ratio [OR] 2.56, p = 0.004) and HGPCa (OR 2.70, p = 0.014) for subjects with PI-RADS grade 3. The present two nomograms based on multivariate analysis outperformed the single PI-RADS in aspects of predicting accuracy for PCa (area under the curve: 0.922 vs. 0.883, p = 0.029) and HGPCa (0.919 vs. 0.873, p = 0.007). Decision-curve analysis also indicated the favorable clinical utility of the present two nomograms. MATERIALS AND METHODS The clinical data of 683 patients who received transrectal ultrasound guided biopsy and prior mp-MRI were reviewed. PPFT was measured as the shortest perpendicular distance from the pubic symphysis to the prostate on MRI. Univariate and multivariate analyses were performed to determine the independent predictors of PCa and HGPCa. We also constructed two nomograms for predicting PCa and HGPCa based on the logistic regression. CONCLUSION The PPFT on mp-MRI is an independent predictor of PCa and HGPCa, notably for patients with PI-RADS grade 3. The nomograms incorporated predictors of PPFT and PI-RADS demonstrated good predictive performance.
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24
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Nassar ZD, Aref AT, Miladinovic D, Mah CY, Raj GV, Hoy AJ, Butler LM. Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer. BJU Int 2018; 121 Suppl 3:9-21. [DOI: 10.1111/bju.14173] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Zeyad D. Nassar
- University of Adelaide Medical School Adelaide SA Australia
- Freemasons Foundation Centre for Men's Health Adelaide SA Australia
- South Australian Health and Medical Research Institute Adelaide SA Australia
| | - Adel T. Aref
- University of Adelaide Medical School Adelaide SA Australia
- Freemasons Foundation Centre for Men's Health Adelaide SA Australia
- South Australian Health and Medical Research Institute Adelaide SA Australia
| | - Dushan Miladinovic
- Discipline of Physiology School of Medical Sciences and Bosch Institute Charles Perkins Centre University of Sydney Sydney NSWAustralia
| | - Chui Yan Mah
- University of Adelaide Medical School Adelaide SA Australia
- Freemasons Foundation Centre for Men's Health Adelaide SA Australia
- South Australian Health and Medical Research Institute Adelaide SA Australia
| | - Ganesh V. Raj
- Departments of Urology and Pharmacology UT Southwestern Medical Center at Dallas Dallas TX USA
| | - Andrew J. Hoy
- Discipline of Physiology School of Medical Sciences and Bosch Institute Charles Perkins Centre University of Sydney Sydney NSWAustralia
| | - Lisa M. Butler
- University of Adelaide Medical School Adelaide SA Australia
- Freemasons Foundation Centre for Men's Health Adelaide SA Australia
- South Australian Health and Medical Research Institute Adelaide SA Australia
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25
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Obesity does not promote tumorigenesis of localized patient-derived prostate cancer xenografts. Oncotarget 2018; 7:47650-47662. [PMID: 27351281 PMCID: PMC5216968 DOI: 10.18632/oncotarget.10258] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 06/09/2016] [Indexed: 12/13/2022] Open
Abstract
There are established epidemiological links between obesity and the severity of prostate cancer. We directly tested this relationship by assessing tumorigenicity of patient-derived xenografts (PDXs) of moderate-grade localized prostate cancer in lean and obese severe combined immunodeficiency (SCID) mice. Mice were rendered obese and insulin resistant by high-fat feeding for 6 weeks prior to transplantation, and PDXs were assessed 10 weeks thereafter. Histological analysis of PDX grafts showed no differences in tumor pathology, prostate-specific antigen, androgen receptor and homeobox protein Nkx-3.1 expression, or proliferation index in lean versus obese mice. Whilst systemic obesity per se did not promote prostate tumorigenicity, we next asked whether the peri-prostatic adipose tissue (PPAT), which covers the prostate anteriorly, plays a role in prostate tumorigenesis. In vitro studies in a cellularized co-culture model of stromal and epithelial cells demonstrated that factors secreted from human PPAT are pro-tumorigenic. Accordingly, we recapitulated the prostate-PPAT spatial relationship by co-grafting human PPAT with prostate cancer in PDX grafts. PDX tissues were harvested 10 weeks after grafting, and histological analysis revealed no evidence of enhanced tumorigenesis with PPAT compared to prostate cancer grafts alone. Altogether, these data demonstrate that prostate cancer tumorigenicity is not accelerated in the setting of diet-induced obesity or in the presence of human PPAT, prompting the need for further work to define the at-risk populations of obesity-driven tumorigenesis and the biological factors linking obesity, adipose tissue and prostate cancer pathogenesis.
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26
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Henning SM, Galet C, Gollapudi K, Byrd JB, Liang P, Li Z, Grogan T, Elashoff D, Magyar CE, Said J, Cohen P, Aronson WJ. Phase II prospective randomized trial of weight loss prior to radical prostatectomy. Prostate Cancer Prostatic Dis 2017; 21:212-220. [PMID: 29203893 PMCID: PMC5986584 DOI: 10.1038/s41391-017-0001-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/01/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Obesity is associated with poorly differentiated and advanced prostate cancer and increased mortality. In preclinical models, caloric restriction delays prostate cancer progression and prolongs survival. We sought to determine if weight loss (WL) in men with prostate cancer prior to radical prostatectomy affects tumor apoptosis and proliferation, and if WL effects other metabolic biomarkers. METHODS In this Phase II prospective trial, overweight and obese men scheduled for radical prostatectomy were randomized to a 5–8 week WL program consisting of standard structured energy-restricted meal plans (1200–1500 Kcal/day) and physical activity or to a control group. The primary endpoint was apoptotic index in the radical prostatectomy malignant epithelium. Secondary endpoints were proliferation (Ki67) in the radical prostatectomy tissue, body weight, body mass index (BMI), waist to hip ratio, body composition, and serum PSA, insulin, triglyceride, cholesterol, testosterone, estradiol, leptin, adiponectin, interleukin 6, interleukin 8, insulin-like growth factor 1, and IGF binding protein 1. RESULTS Twenty-three patients were randomized to the WL intervention and twenty-one patients to the control group. Subjects in the intervention group had significantly more weight loss (WL:−3.7 ± 0.5 kg; Control:−1.6 ± 0.5 kg; p=0.007) than the control group and total fat mass was significantly reduced (WL:−2.1 ± 0.4; Control: 0.1 ± 0.3; p=0.015). There was no significant difference in apoptotic or proliferation index between the groups. Among the other biomarkers, triglyceride and insulin levels were significantly decreased in the WL compared to the control group. CONCLUSIONS In summary, this short-term WL program prior to radical prostatectomy resulted in significantly more WL in the intervention vs. the control group and was accompanied by significant reductions in body fat mass, circulating triglycerides, and insulin. However, no significant changes were observed in malignant epithelium apoptosis or proliferation. Future studies should consider a longer term or more intensive weight loss intervention.
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Affiliation(s)
- Susanne M Henning
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Colette Galet
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Kiran Gollapudi
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Joshua B Byrd
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Pei Liang
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Zhaoping Li
- Center for Human Nutrition, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90024-2703, USA
| | - Tristan Grogan
- Statistics Core, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - David Elashoff
- Statistics Core, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Clara E Magyar
- Department of Pathology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Jonathan Said
- Department of Pathology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA
| | - Pinchas Cohen
- USC Davis School of Gerontology, Ethel Percy Andrus Gerontology Center University of Southern California, Los Angeles, 90089-0191, CA, USA
| | - William J Aronson
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA. .,VA Medical Center Greater Los Angeles Healthcare System, 11301 Whilshire Blvd, Los Angeles, 90073-1003, CA, USA.
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27
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Dahran N, Szewczyk-Bieda M, Wei C, Vinnicombe S, Nabi G. Normalized periprostatic fat MRI measurements can predict prostate cancer aggressiveness in men undergoing radical prostatectomy for clinically localised disease. Sci Rep 2017; 7:4630. [PMID: 28680067 PMCID: PMC5498487 DOI: 10.1038/s41598-017-04951-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022] Open
Abstract
Periprostatic and pelvic fat have been shown to influence prostate cancer behaviour through the secretion of chemokines and growth factors, acting in a paracrine mode. We have measured periprostatic fat volume (PFV) with normalisation to prostate gland volume on pelvic magnetic resonance imaging (MRI) and have correlated this with grade (Gleason score; GS) and pathological staging (pT) of prostate cancer (PCa) following radical prostatectomy (RP). PFV was determined using a segmentation technique on contiguous T1-weighted axial MRI slices from the level of the prostate base to the apex. The abdominal fat area (AFA) and subcutaneous fat thickness (SFT) were measured using T1-weighted axial slices at the level of the umbilicus and the upper border of the symphysis pubis, respectively. PFV was normalised to prostate volume (PV) to account for variations in PV (NPFV = PFV/PV). Patients were stratified into three risk groups according to post-operative GS: ≤6, 7(3 + 4), and ≥7(4 + 3). NPFV was significantly different between the groups (p = 0.001) and positively correlated with post-operative GS (ρ = 0.294, p < 0.001). There was a difference in NPFV between those with upgrading of GS from 6 post prostatectomy (2.43 ± 0.98; n = 26) compared to those who continued to be low grade (1.99 ± 0.82; n = 17); however, this did not reach statistical significance (p = 0.11).
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Affiliation(s)
- Naief Dahran
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK
- Department of Anatomy, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | - Cheng Wei
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK
| | - Sarah Vinnicombe
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK
| | - Ghulam Nabi
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK.
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28
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Taussky D, Barkati M, Campeau S, Zerouali K, Nadiri A, Saad F, Delouya G. Changes in periprostatic adipose tissue induced by 5α-reductase inhibitors. Andrology 2017; 5:511-515. [DOI: 10.1111/andr.12331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/02/2016] [Accepted: 12/28/2016] [Indexed: 01/06/2023]
Affiliation(s)
- D. Taussky
- Department of Radiation Oncology; Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame; Montréal QC Canada
- CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
| | - M. Barkati
- Department of Radiation Oncology; Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame; Montréal QC Canada
- CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
| | - S. Campeau
- Department of Radiation Oncology; Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame; Montréal QC Canada
| | - K. Zerouali
- Department of Physics; Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
| | - A. Nadiri
- Department of Radiation Oncology; Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame; Montréal QC Canada
- CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
| | - F. Saad
- CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
- Section of Urology; Department of Surgery; Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
| | - G. Delouya
- Department of Radiation Oncology; Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame; Montréal QC Canada
- CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal; Montréal QC Canada
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29
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Ferro M, Terracciano D, Buonerba C, Lucarelli G, Bottero D, Perdonà S, Autorino R, Serino A, Cantiello F, Damiano R, Andras I, De Placido S, Di Lorenzo G, Battaglia M, Jereczek-Fossa BA, Mirone V, De Cobelli O. The emerging role of obesity, diet and lipid metabolism in prostate cancer. Future Oncol 2016; 13:285-293. [PMID: 27624840 DOI: 10.2217/fon-2016-0217] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Obesity is associated with an increased risk of a number of serious medical conditions, including cancer. As far as prostate cancer is concerned, obesity is associated with an increased risk of high-grade tumors, which is possibly related to lower androgen levels. Diet may also affect prostate cancer risk since countries with a higher dietary fat intake also present higher prostate cancer mortality rates. Interestingly, prostate cancer is associated with a number of metabolic alterations that may provide valuable diagnostic and therapeutic targets. This review explores the available clinical as well as biological evidence supporting the relationship between obesity, diet, alteration in metabolic pathways and prostate cancer.
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Affiliation(s)
- Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), Milan, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University 'Federico II', Naples, Italy
| | - Carlo Buonerba
- Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Giuseppe Lucarelli
- Department of Emergency & Organ Transplantation - Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Danilo Bottero
- Department of Urology, European Institute of Oncology (IEO), Milan, Italy
| | - Sisto Perdonà
- Department of Urology, National Cancer Institute of Naples, Naples, Italy
| | - Riccardo Autorino
- Urology Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Alessandro Serino
- Department of Urology, European Institute of Oncology (IEO), Milan, Italy
| | - Francesco Cantiello
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Sabino De Placido
- Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine & Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Michele Battaglia
- Department of Emergency & Organ Transplantation - Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Barbara A Jereczek-Fossa
- Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.,Department of Oncology & Hemato-oncology, University of Milan, Milan, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction & Odontostomatology, University Federico II of Naples, Via Sergio Pansini, 80131 Naples, Italy
| | - Ottavio De Cobelli
- Department of Urology, European Institute of Oncology (IEO), Milan, Italy.,UMF Iuliu Hatieganu, Cluj-Napoca, Romania.,University of Milan, Milan, Italy
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Jiang L, Jiang S, Lin Y, Yang H, Zhao Z, Xie Z, Lin Y, Long H. Combination of body mass index and oxidized low density lipoprotein receptor 1 in prognosis prediction of patients with squamous non-small cell lung cancer. Oncotarget 2016; 6:22072-80. [PMID: 26061746 PMCID: PMC4673147 DOI: 10.18632/oncotarget.4299] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 05/22/2015] [Indexed: 01/23/2023] Open
Abstract
Lung cancer, especially non-small cell lung cancer (NSCLC), represents enormous challenges in continuously achieving treatment improvements. Besides cancer, obesity is becoming ever more prevalent. Obesity is increasingly acknowledged as a major risk factor for several types of common cancers. Significant mechanisms overlap in the pathobiology of obesity and tumorigenesis. One of these mechanisms involves oxidized low density lipoprotein receptor 1 (OLR1), as a link between obesity and cancer. Additionally, body mass index (BMI) has been widely used in exploiting the role of obesity on a series of diseases, including cancer. Significantly, squamous NSCLC revealed to be divergent clinical and molecular phenotypes compared with non-squamous NSCLC. Consequently, OLR1 immunostaining score and BMI were assessed by Fisher's linear discriminant analysis to discriminate if progression-free survival (PFS) would exceed 2 years. In addition, the final model was utilized to calculate the discriminant score in each study participant. Finally, 131 patients with squamous NCSLC were eligible for analysis. And a prediction model was established for PFS based on these 2 markers and validated in a second set of squamous NCSLC patients. The model offers a novel tool for survival prediction and could establish a framework for future individualized therapy for patients with squamous NCSLC.
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Affiliation(s)
- Long Jiang
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.,University of California, San Francisco, San Francisco, CA, USA
| | - Shanshan Jiang
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yongbin Lin
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Han Yang
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Zerui Zhao
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Zehua Xie
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yaobin Lin
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hao Long
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Lung Cancer Institute of Sun Yat-Sen University, Guangzhou, China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
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Abstract
The global epidemic of obesity is closely linked to the development of serious co-morbidities, including many forms of cancer. Epidemiological evidence consistently shows that obesity is associated with a similar or mildly increased incidence of prostate cancer but, more prominently, an increased risk for aggressive prostate cancer and prostate cancer-specific mortality. Studies in mice demonstrate that obesity induced by high-fat feeding increases prostate cancer progression; however, the mechanisms underpinning this relationship remain incompletely understood. Adipose tissue expansion in obesity leads to local tissue dysfunction and is associated with low-grade inflammation, alterations in endocrine function and changes in lipolysis that result in increased delivery of fatty acids to tissues of the body. The human prostate gland is covered anteriorly by the prominent peri-prostatic adipose tissue and laterally by smaller adipose tissue depots that lie directly adjacent to the prostatic surface. We discuss how the close association between dysfunctional adipose tissue and prostate epithelial cells might result in bi-directional communication to cause increased prostate cancer aggressiveness and progression. However, the literature indicates that several 'mainstream' hypotheses regarding obesity-related drivers of prostate cancer progression are not yet supported by a solid evidence base and, in particular, are not supported by experiments using human tissue. Understanding the links between obesity and prostate cancer will have major implications for the health policy for men with prostate cancer and the development of new therapeutic or preventative strategies.
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Affiliation(s)
- Renea A Taylor
- Department of PhysiologyCancer Program and Obesity and Metabolic Disease Program, Biomedicine Discovery Institute, Monash University, Wellington Road, Victoria 3800, Australia
| | - Jennifer Lo
- Department of PhysiologyCancer Program and Obesity and Metabolic Disease Program, Biomedicine Discovery Institute, Monash University, Wellington Road, Victoria 3800, Australia
| | - Natasha Ascui
- Department of PhysiologyCancer Program and Obesity and Metabolic Disease Program, Biomedicine Discovery Institute, Monash University, Wellington Road, Victoria 3800, Australia
| | - Matthew J Watt
- Department of PhysiologyCancer Program and Obesity and Metabolic Disease Program, Biomedicine Discovery Institute, Monash University, Wellington Road, Victoria 3800, Australia
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Periprostatic fat thickness on MRI: correlation with Gleason score in prostate cancer. AJR Am J Roentgenol 2015; 204:W43-7. [PMID: 25539273 DOI: 10.2214/ajr.14.12689] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to retrospectively evaluate the relationship between periprostatic fat thickness on MRI and Gleason score of prostate cancer using radical prostatectomy as the reference standard. MATERIALS AND METHODS This study included 190 patients (mean age [± SD], 66.9 ± 7.0 years) who underwent MRI before radical prostatectomy. Two radiologists measured the subcutaneous and periprostatic fat thickness on midsagittal T2-weighted MR images as the shortest perpendicular distance from the pubic symphysis to the skin and prostate, respectively. Subcutaneous and periprostatic fat along with age, height, weight, body mass index, and prostate-specific antigen (PSA) were correlated with Gleason score by using Pearson (r) or Spearman (ρ) correlation coefficients and compared between low- (Gleason score = 6) and high- (≥ 7) grade prostate cancer by using univariate and multivariate logistic regression analyses. RESULTS The mean subcutaneous and periprostatic fat thicknesses were 24.0 ± 8.4 mm and 5.0 ± 2.0 mm, respectively. The Gleason score was significantly correlated with age (ρ = 0.181, p = 0.012), PSA (ρ = 0.345, p < 0.001), and periprostatic fat thickness (ρ = 0.228, p = 0.002). Multivariate analysis revealed that age, height, PSA level, and periprostatic fat thickness (odds ratio, 1.331; 95% CI, 1.063-1.666) were independently predictive of high-grade (p ≤ 0.013) disease. CONCLUSION Periprostatic fat thickness on MRI showed a mild to modest but significant correlation with Gleason score of prostate cancer with radical prostatectomy as the reference standard and was an independent predictive factor for high-grade prostate cancer.
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Iordanescu G, Brendler C, Crawford SE, Wyrwicz AM, Venkatasubramanian PN, Doll JA. MRS measured fatty acid composition of periprostatic adipose tissue correlates with pathological measures of prostate cancer aggressiveness. J Magn Reson Imaging 2014; 42:651-7. [PMID: 25522916 DOI: 10.1002/jmri.24824] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/01/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate the association between magnetic resonance (MR) spectroscopically measured fatty acid composition of periprostatic adipose tissue and pathological markers of prostate cancer aggressiveness. MATERIALS AND METHODS Periprostatic adipose (PPA) and subcutaneous adipose (SQA) tissue from prostate cancer patients undergoing radical prostatectomy were examined ex vivo by proton MR spectroscopy at 14.1T (n = 31). Fractions of monounsaturated, polyunsaturated, total unsaturated, and saturated fatty acids, as well as T2 relaxation times were measured from the spectra. Univariate and multivariate analyses based on receiver operating characteristic (ROC) and support vector machines (SVM) were used to evaluate the association between differential measures of fatty acid levels in the PPA and SQA tissues and Gleason score and extracapsular extension (ECE), which are pathological measures of prostate cancer aggressiveness. RESULTS Both pathological markers for aggressive prostate cancer have separable patterns in the MRS features space. The association between ECE and PPA tissue fatty acid composition is linear (area under receiver operating characteristic curve (AROC) and 95% confidence intervals [CIs]: 1.00, [1.00, 1.00]), along the Δ(fM /fS ) measure, and is marked by elevated monounsaturated and reduced saturated fatty acids in the PPA tissue relative to SQA. In contrast, the association between Gleason score and PPA tissue fatty acid composition is nonlinear (classifier AROC and 95% CIs: 0.86, [0.71, 1.00]). CONCLUSION Fatty acid composition is altered in the PPA tissue of patients with aggressive prostate cancer. Ex vivo MR spectroscopy may be a useful tool in studying the altered fatty acid metabolism in prostate cancer.
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Affiliation(s)
- Gheorghe Iordanescu
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Charles Brendler
- Division of Urology, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Susan E Crawford
- Department of Pathology, St. Louis University, St. Louis, Missouri, USA
| | - Alice M Wyrwicz
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, USA
| | | | - Jennifer A Doll
- Department of Biomedical Sciences, University of Wisconsin at Milwaukee, Milwaukee, Wisconsin, USA
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Den Hollander PP, Rademakers KLJ, van Roermund JGH. Is periprostatic adipose tissue associated with aggressive tumor biology in prostate cancer? World J Clin Urol 2014; 3:320-324. [DOI: 10.5410/wjcu.v3.i3.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/17/2014] [Accepted: 09/17/2014] [Indexed: 02/06/2023] Open
Abstract
The prevalence of overweight and obesity and their health-related problems have been increasing. Obesity is increasingly recognized as a risk factor in different types of cancer in humans. The mechanisms supporting the link between obesity and cancer development have not been fully understood. Leptin, a circulating cytokine produced by adipocytes, may influence prostate cancer (PCa) progression in different ways. Body mass index seems to be an unreliable predictor for the development of PCa, but its influence on progression and poor oncological outcomes seems to be clear. Given the fact that abdominal fat is the most metabolically active fat, with different metabolic and paracrine effects, related anthropometric measurements may lead to a better estimation of PCa risk. Metabolically active periprostatic abdominal fat may also play an important role in releasing cytokines and growth factors that may promote tumor cell proliferation or even create a favorable environment for aggressive tumor biology. Different imaging measurements, e.g., periprostatic adipose tissue (PPAT) thickness, may be significant predictors of PCa. Several genes in the PPAT of obese men have been identified to contribute to chronic immuno-inflammatory responses which eventually lead to cell cycle alteration with oncological potential. In vitro studies showed the importance of PCa and its interaction with its microenvironment particularly in patients with aggressive PCa. Different types of cytokines, such as interleukin-6, may promote a tumorigenic microenvironment. This article endeavors to review the current literature on the association of PPAT with aggressive tumor biology in PCa.
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Tiberi D, Gruszczynski N, Meissner A, Delouya G, Taussky D. Influence of body mass index and periprostatic fat on rectal dosimetry in permanent seed prostate brachytherapy. Radiat Oncol 2014; 9:93. [PMID: 24731303 PMCID: PMC4002200 DOI: 10.1186/1748-717x-9-93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 04/05/2014] [Indexed: 11/10/2022] Open
Abstract
PURPOSE We examined the influence of body mass index (BMI) and body fat distribution on rectal dose in patients treated with permanent seed brachytherapy for localized prostate cancer. METHODS AND MATERIALS We analyzed 213 patients treated with I125 seed brachytherapy for localized prostate cancer. BMI and rectal dosimetry data for all patients were available. Data on visceral and subcutaneous fat distribution at the level of the iliac crest (n = 140) as well as the distribution of periprostatic and subcutaneous fat at the symphysis pubis level were obtained (n = 117). Fat distribution was manually contoured on CT on day 30 after brachytherapy. The correlation between BMI, fat distribution and rectal dose (R100 (in cc), R150 (cc), D2 (Gy)) was analyzed using the Spearman correlation coefficient. Differences in rectal dose between tertiles of body fat distribution were calculated using nonparametric tests. RESULTS Periprostatic adipose was only weakly correlated with BMI (r = 0.0.245, p = 0.008) and only weakly correlated with the other fat measurements (r = 0.31-0.37, p < 0.001). On the other hand, BMI was correlated with all other fat measurements (≥0.58, p < 0.001). All the other fat measurements were strongly correlated with each other (r = 0.5-0.87, p < 0.001). Patients with an R100 of >1.3 cc (23% of patients) had less visceral fat (p = 0.004), less subcutaneous fat at the level of the iliac crest (p = 0.046) and a lower BMI (26.8 kg/m2 vs. 28.5 kg/m2, p = 0.02) than patients with an R100 of <1.3 cc. Results were very similar when comparing an R100 of >1.0 cc (34% of patients) across the tertiles. None of the tested linear regression models were predictive (max 12%) of dose to the rectum. CONCLUSION Dose to the rectum is dependent on BMI and body fat distribution. Periprostatic fat does not influence rectal dose. Dose to the rectum remains difficult to predict and depends on many factors, one of which is body fat distribution.
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Affiliation(s)
| | | | | | | | - Daniel Taussky
- Département de Radio-Oncologie, Centre Hospitalier de l'Université de Montréal (CHUM) - Hôpital Notre-Dame, Montréal, Québec, Canada.
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Bhindi B, Locke J, Alibhai SMH, Kulkarni GS, Margel DS, Hamilton RJ, Finelli A, Trachtenberg J, Zlotta AR, Toi A, Hersey KM, Evans A, van der Kwast TH, Fleshner NE. Dissecting the association between metabolic syndrome and prostate cancer risk: analysis of a large clinical cohort. Eur Urol 2014; 67:64-70. [PMID: 24568896 DOI: 10.1016/j.eururo.2014.01.040] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 01/31/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND A biologic rationale exists for the association between metabolic syndrome (MetS) and prostate cancer (PCa). However, epidemiologic studies have been conflicting. OBJECTIVE To evaluate the association between MetS and the odds of PCa diagnosis in men referred for biopsy. DESIGN, SETTING, AND PARTICIPANTS Patients without prior PCa diagnosis undergoing prostate biopsy were identified from a large prostate biopsy cohort (in Toronto, Canada). The definition of MetS was based on the most recent interim joint consensus definition, requiring any three of five components (obesity, elevated blood pressure, diabetes or impaired fasting glucose, low high-density lipoprotein-cholesterol, and hypertriglyceridemia). Both the individual components of MetS and the cumulative number of MetS components were evaluated. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The outcomes were PCa detection overall, clinically significant PCa (CSPC; defined as any Gleason pattern ≥ 4, >50% involvement of a single biopsy core, or more than one of three total number of cores involved), and intermediate- or high-grade PCa (I-HGPC; Gleason 7-10). Tests for trend and multivariable logistic regression analyses were performed. RESULTS AND LIMITATIONS Of 2235 patients, 494 (22.1%) had MetS. No individual MetS component was independently associated with PCa. However, increasing number of MetS components was associated with higher PCa grade (p<0.001), as well as progressively higher odds of PCa outcomes (three or more; ie, MetS) compared with no MetS components: Odds ratios were 1.54 for PCa overall (95% confidence interval [CI], 1.17-2.04; p=0.002), 1.56 for CSPC (95% CI, 1.17-2.08; p=0.002), and 1.56 for I-HGPC (95% CI, 1.16-2.10; p=0.003) in multivariable analyses. The main limitation is the retrospective design. CONCLUSIONS Although the individual MetS components are not independently associated with PCa outcomes, MetS is significantly associated with higher odds of PCa diagnosis, CSPC, and I-HGPC. There is a biologic gradient between the number of MetS components and the risk of PCa, as well as cancer grade. PATIENT SUMMARY Metabolic syndrome is a collection of metabolic abnormalities that increases one's risk for heart disease. Our study shows that an increasing degree of metabolic abnormality is also associated with an increased risk of diagnosis of overall and aggressive prostate cancer.
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Affiliation(s)
- Bimal Bhindi
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
| | - Jennifer Locke
- Division of Urology, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shabbir M H Alibhai
- Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Girish S Kulkarni
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, Ontario, Canada
| | - David S Margel
- Division of Urology and Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - Robert J Hamilton
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - John Trachtenberg
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Alexandre R Zlotta
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ants Toi
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Karen M Hersey
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Evans
- Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Neil E Fleshner
- Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Venkatasubramanian PN, Brendler CB, Plunkett BA, Crawford SE, Fitchev PS, Morgan G, Cornwell ML, McGuire MS, Wyrwicz AM, Doll JA. Periprostatic adipose tissue from obese prostate cancer patients promotes tumor and endothelial cell proliferation: a functional and MR imaging pilot study. Prostate 2014; 74:326-35. [PMID: 24571013 DOI: 10.1002/pros.22756] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obesity, particularly visceral adiposity, confers a worse prognosis for prostate cancer (PCa) patients, and increasing periprostatic adipose (PPA) tissue thickness or density is positively associated with more aggressive disease. However, the cellular mechanism of this activity remains unclear. Therefore, in this pilot study, we assessed the functional activity of PPA tissue secretions and established a biochemical profile of PPA as compared to subcutaneous adipose (SQA) tissues from lean, overweight and obese PCa patients. METHODS Adipose tissues were collected from PCa patients undergoing surgical prostate removal. Tissues were analyzed by histologic and magnetic resonance (MR) techniques. Explant tissue culture secretions were used in proliferation assays on PCa and endothelial cells. RESULTS PPA secretions obtained from obese patients were significantly more pro-proliferative in both PCa and endothelial cells as compared to PPA obtained from lean or overweight men and SQA tissues. Consistent with this, PPA microvessel density was increased, and the T2 relaxation time was decreased, compared to SQA tissues, and we observed a modest, inverse correlation between the T2 and tumor stage. Moreover, the ratio of unsaturated to saturated fatty acids, obtained using MR spectroscopy, showed a modest, inverse correlation with Gleason score. CONCLUSIONS These pilot data show that PPA stimulates PCa cell proliferation and angiogenesis and that obesity intensifies this activity, thus generating a mechanistic hypothesis to explain the worse prognosis observed in obese PCa patients. Our pilot study also shows that MR technology may be useful in further elucidating the relationship between obesity and PCa progression.
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Toren P, Venkateswaran V. Periprostatic adipose tissue and prostate cancer progression: new insights into the tumor microenvironment. Clin Genitourin Cancer 2013; 12:21-6. [PMID: 24269373 DOI: 10.1016/j.clgc.2013.07.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 07/23/2013] [Accepted: 07/31/2013] [Indexed: 01/04/2023]
Affiliation(s)
- Paul Toren
- Vancouver Prostate Centre, University of British Columbia, British Columbia, Canada
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Ribeiro R, Monteiro C, Silvestre R, Castela A, Coutinho H, Fraga A, Príncipe P, Lobato C, Costa C, Cordeiro-da-Silva A, Lopes JM, Lopes C, Medeiros R. Human periprostatic white adipose tissue is rich in stromal progenitor cells and a potential source of prostate tumor stroma. Exp Biol Med (Maywood) 2012; 237:1155-62. [PMID: 23038706 DOI: 10.1258/ebm.2012.012131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A body of growing evidence now implicates white adipose tissue as a relevant source of stromal progenitor cells recruited to the tumor microenvironment to form supportive tumor stroma. While the role of periprostatic (PP) adipose tissue in prostate cancer progression has been barely appreciated, we sought to determine the progenitor cell population in PP adipose tissue and the association with prostate cancer. We isolated and characterized CD31(-)CD34(+)CD45(-)CD146(-) progenitor cells (adipose-derived stem cells [ASC]) in paired samples of PP and preperitoneal visceral adipose tissue from prostate tissue and peripheral blood mononuclear cells of prostate cancer and nodular prostatic hyperplasia patients. ASC were quantified by flow cytometry and confirmed through target gene expression. Here we show a significantly higher amount of ASC in PP than in visceral adipose tissue, independent of body mass index and prostatic disease. In the prostate, ASC are increased in cancer compared with prostatic nodular hyperplasia patients. Concordantly, adipsin gene (CFD) expression, which is known to be up-regulated in adipose stem cells, was overexpressed in PP adipose tissue, in the prostate of cancer patients and in prostate CD31(-)CD34(+)CD45(-)CD146(-) sorted cells. ASC were found at higher levels in the blood of prostate cancer patients simultaneously overweight/obese. Present findings indicate that PP adipose tissue is a reservoir of progenitor cells with the potential to migrate towards prostate tumors, although its clinical significance merits further evaluation.
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Affiliation(s)
- Ricardo Ribeiro
- Molecular Oncology Group-CI, Portuguese Institute of Oncology, Rua Dr. António Bernardino Almeida, Porto, Portugal
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