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Pan X, Tan J, Yin X, Liu Q, Zheng L, Su Z, Zhou Q, Chen N. The roles of mutated SPINK1 gene in prostate cancer cells. Mutagenesis 2022; 37:238-247. [PMID: 36112498 DOI: 10.1093/mutage/geac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/07/2022] [Indexed: 12/31/2022] Open
Abstract
SPINK1-positive prostate cancer (PCa) has been identified as an aggressive PCa subtype. However, there is a lack of definite studies to elucidate the underlying mechanism of the loss of SPINK1 expression in most PCa cells except 22Rv1 cells, which are derived from a human prostatic carcinoma xenograft, CWR22R. The aim of this study was to investigate the mechanisms of SPINK1 protein positive/negative expression and its biological roles in PCa cell lines. SPINK1 mRNA was highly expressed in 22Rv1 cells compared with LNCaP, C4-2B, DU145, and PC-3 cells, and the protein was only detected in 22Rv1 cells. Among these cell lines, the wild-type SPINK1 coding sequence was only found in 22Rv1 cells, and two mutation sites, the c.194G>A missense mutation and the c.210T>C synonymous mutation, were found in other cell lines. Our further research showed that the mutations were associated with a reduction in SPINK1 mRNA and protein levels. Functional experiments indicated that SPINK1 promoted PC-3 cell proliferation, migration, and invasion, while knockdown of SPINK1 attenuated 22Rv1 cell proliferation, migration, and invasion. The wild-type SPINK1 gene can promote the malignant behaviors of cells more than the mutated ones. Cell cycle analysis by flow cytometry showed that SPINK1 decreased the percentage of cells in the G0/G1 phase and increased the percentage of S phase cells. We demonstrated that the c.194G>A and c.210T>C mutations in the SPINK1 gene decreased the mRNA and protein levels. The wild-type SPINK1 gene is related to aggressive biological behaviors of PCa cells and may be a potential therapeutic target for PCa.
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Affiliation(s)
- Xiuyi Pan
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Junya Tan
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoxue Yin
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qianqi Liu
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Linmao Zheng
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhengzheng Su
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiao Zhou
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ni Chen
- Pathology Department, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
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2
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Lakshmanan VK, Ojha S, Jung YD. A modern era of personalized medicine in the diagnosis, prognosis, and treatment of prostate cancer. Comput Biol Med 2020; 126:104020. [PMID: 33039808 DOI: 10.1016/j.compbiomed.2020.104020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022]
Abstract
The present era is witnessing rapid advancements in the field of medical informatics and modern healthcare management. The role of translational bioinformatics (TBI), an infant discipline in the field of medical informatics, is pivotal in this revolution. The development of high-throughput technologies [e.g., microarrays, next-generation sequencing (NGS)] has propelled TBI to the next stage in this modern era of medical informatics. In this review, we assess the promising translational outcomes of microarray- and NGS-based discovery of genes, proteins, micro RNAs, and other active biological compounds aiding in the diagnosis, prognosis, and therapy of prostate cancer (PCa) to improve treatment strategies at the localized and/or metastatic stages in patients. Several promising candidate biomarkers in circulating blood (miR-25-3p and miR-18b-5p), urine (miR-95, miR-21, miR-19a, and miR-19b), and prostatic secretions (miR-203) have been identified. AURKA and MYCN, novel candidate biomarkers, were found to be specifically expressed in neuroendocrine PCa. The use of BTNL2 gene mutations and inflammasomes as biomarkers in immune function-mediated, inherited PCa has also been elucidated based on NGS data. Although TBI discoveries can benefit clinical performance metrics, the translational potential and the in vivo performance of TBI outcomes need to be verified. In conclusion, TBI aids in the effective clinical management of PCa; furthermore, the fate of personalized/precision medicine mostly relies on the enhanced diagnostic, prognostic, and therapeutic potential of TBI.
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Affiliation(s)
- Vinoth-Kumar Lakshmanan
- Centre for Preclinical and Translational Medical Research (CPTMR), Central Research Facility (CRF), Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600 116, Tamil Nadu, India; Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, 4184, United Arab Emirates.
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Young Do Jung
- Department of Biochemistry, Chonnam National University Medical School, 160 Baeksuh-Roh, Dong Gu, Gwangju, 61469, Republic of Korea
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3
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Ross J, Li G, Yang XJ. Application and Pitfalls of Immunohistochemistry in Diagnosis of Challenging Genitourinary Cases. Arch Pathol Lab Med 2020; 144:290-304. [PMID: 32101059 DOI: 10.5858/arpa.2019-0550-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Immunohistochemistry (IHC) has become increasingly important in the evaluation of pathologic conditions in the genitourinary (GU) organs. In addition to careful evaluation of hematoxylin-eosin sections and generation of a differential diagnosis, choosing the optimal panel of IHC markers becomes even more important when the biopsy material is very limited. The following summary of our experience supplemented with relevant literature review exemplifies how to use IHC to facilitate pathologic diagnosis in the GU system. OBJECTIVE.— To describe our experience with the most common immunohistochemical markers used in GU pathology. DATA SOURCES.— Institutional experience and literature search comprise our data sources. CONCLUSIONS.— Application of IHC provides enormous benefits to the interpretation of GU pathologic conditions, including benign and malignant lesions. However, both insufficient and excessive types of use of IHC, as well as incorrect interpretations in common and rare GU conditions, could present pitfalls in diagnosis.
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Affiliation(s)
- Jenny Ross
- From the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Guangyuan Li
- From the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ximing J Yang
- From the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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4
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Wang ZC, Li Y, Wang KL, Wang L, You BS, Zhao DF, Liu ZQ, Fang RZ, Wang JQ, Zhang W, Zhang JM, Xu WH. miR-5089-5p suppresses castration-resistant prostate cancer resistance to enzalutamide and metastasis via miR-5089-5p/SPINK1/ MAPK/MMP9 signaling. Aging (Albany NY) 2020; 12:14418-14433. [PMID: 32694237 PMCID: PMC7425449 DOI: 10.18632/aging.103485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/27/2020] [Indexed: 01/19/2023]
Abstract
Whether serine protease inhibitor Kazal type 1 (SPINK1) being associated with enzalutamide (Enz) resistance and metastasis of castration-resistant prostate cancer (CRPC) has not been clear. SPINK1 promoted Enz resistance by upregulating Androgen receptor splicing variant 7 (ARv7), and enhanced the invasion/migration of Enz-resistant cells via ERK/p38/ MMP9 signaling. Furthermore, miR-5089-5p suppressed SPINK1 mRNA through direct binding to its 3'UTR, and reversed its pro-proliferative and pro-metastatic effects. Mice bearing SPINK1-knockdown Enz-resistant PCa tumors showed significantly longer survival compared with those bearing wild-type tumors, while treatment with miR-5089-5p inhibitor abrogated the protective effects of SPINK1 knockdown. Taken together, SPINK1 can be used as a biomarker of resistance to Enz, and the miR-5089-5p/SPINK1/MAPK/MMP9 axis is a suitable therapeutic target against Enz-resistant and metastatic CRPC. Methods: The expression of SPINK1 in Enz-resistant prostate cancer (PCa) cell lines was detected through next-generation sequencing data and metastatic PCa patients. In vivo and in vitro experiments were performed to investigate the role of SPINK1 in Enz-resistance and metastasis.
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Affiliation(s)
- Zhi-Chao Wang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Yan Li
- Department of Anesthesia, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Ke-Liang Wang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Lu Wang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Bo-Sen You
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Dan-Feng Zhao
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Zhong-Qing Liu
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Rui-Zhe Fang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Jia-Qi Wang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Wei Zhang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Jin-Ming Zhang
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Wan-Hai Xu
- Heilongjiang Key Laboratory of Scientific Research in Urology, The Forth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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5
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Kremer A, Kremer T, Kristiansen G, Tolkach Y. Where is the limit of prostate cancer biomarker research? Systematic investigation of potential prognostic and diagnostic biomarkers. BMC Urol 2019; 19:46. [PMID: 31170942 PMCID: PMC6554887 DOI: 10.1186/s12894-019-0479-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The identification of appropriate biomarkers is essential to support important clinical decisions in patients with prostate cancer. The aim of our study was a systematic bioinformatical analysis of the mRNA expression of all genes available for the prostate adenocarcinoma cohort of The Cancer Genome Atlas (TCGA), regarding their potential prognostic and diagnostic role. METHODS The study cohort comprises 499 patients (TCGA prostate cancer cohort). mRNA expression data were available for approx. 20,000 genes. The bioinformatical statistical pipeline addressed gene expression differences in tumor vs. benign prostate tissue (including gene set enrichment analysis, GSEA) in samples from tumors with different aggressivenesses (Gleason score), as well as prognostic values in multistep survival analyses. RESULTS Among all genes analyzed, 1754 were significantly downregulated and 1553 genes were significantly upregulated in tumor tissue. In GSEA, 16 of 30 top enriched biological processes were alterations of epigenetic regulation at different levels. Significant correlation with Gleason Score was evident for 8724 genes (range of Pearson r-values 0.09-0.43; all p < 0.05). In univariate Cox regression analyses, mRNA expression of 3571 genes showed statistically significant association with biochemical recurrence-free survival with a range of hazard ratios 0.3-3.8 (p-value 7.4e- 07 to 0.05). Among these, 571 genes were independently associated with biochemical recurrence in multivariate analysis. Access to the full database including results is provided as supplement. CONCLUSIONS In our systematic analysis we found a big number of genes of potential diagnostic and prognostic value, many of which have not been studied in prostate cancer to date. Due to the comprehensive nature of this analysis and free access to the results, this study represents a reference database for prostate cancer researchers which can be used as a powerful tool for validation purposes and planning of new studies.
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Affiliation(s)
- Anika Kremer
- Institute of Pathology, University Hospital of Bonn, Bonn, Germany
| | - Tobias Kremer
- Institute of Computer Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Glen Kristiansen
- Institute of Pathology, University Hospital of Bonn, Bonn, Germany
| | - Yuri Tolkach
- Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
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6
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Carneiro A, Barbosa ÁRG, Takemura LS, Kayano PP, Moran NKS, Chen CK, Wroclawski ML, Lemos GC, da Cunha IW, Obara MT, Tobias-Machado M, Sowalsky AG, Bianco B. The Role of Immunohistochemical Analysis as a Tool for the Diagnosis, Prognostic Evaluation and Treatment of Prostate Cancer: A Systematic Review of the Literature. Front Oncol 2018; 8:377. [PMID: 30280090 PMCID: PMC6153326 DOI: 10.3389/fonc.2018.00377] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/23/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Prostate cancer (PCa) is a heterogeneous disease that lends itself toward numerous therapeutic options depending on its risk stratification. One of the greatest challenges in PCa urologic practice is to select patients who should be referred for biopsy and, for those patients who are diagnosed with cancer, to differentiate between patients with indolent disease from those with an unfavorable prognosis and, to determine ideal patient management and avoid unnecessary interventions. Accordingly, there is a growing body of literature reporting immunohistochemical studies with the objective of determining a prostate cancer prognosis. Among the most frequent biomarkers studied are Ki-67, p53, PTEN, MYC, and ERG. Based on these findings, we systematically reviewed articles that assessed the role of these main prognostic markers in prostate cancer. Methods: Consistent with PRISMA guidelines, we performed a systematic literature search throughout the Web of Science and PubMed Medline databases. We considered all types of studies evaluating the role of Ki-67, p53, PTEN, MYC, and ERG immunohistochemical analysis in prostate cancer until July 2017. Results: We identified 361 articles, 44 of which were summarized in this review. Diagnostically, no single immunohistochemical marker was able to define a tumor as benign or malignant. Prognostically, Ki-67, p53, and MYC were related to the tumor grade given by Gleason score and to the tumor stage (higher levels related to higher tumor grade). Furthermore, Ki-67 was also related to higher PSA levels, shorter disease-free intervals and shorter tumor-specific survival; the latter was also related to p53. The loss of PTEN protein expression showed a higher association with biochemical recurrence and with a worse prognosis, beyond that predicted by the Gleason score and tumor stage. ERG staining also showed a strong association with biochemical recurrence. Conclusion: There are several studies relating immunohistochemical markers with clinical-laboratorial outcomes in prostate cancer, the most frequent being Ki-67, p53, ERG, PTEN, and MYC. However, none of these markers have been validated by literary consensus to be routinely applied in medical practice.
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Affiliation(s)
- Arie Carneiro
- Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | | | | | - Carolina Ko Chen
- Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marcelo Langer Wroclawski
- Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | - Marcos Takeo Obara
- Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Adam G Sowalsky
- Laboratory of Genitourinary Cancer Pathogenesis, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Bianca Bianco
- Human Reproduction and Genetics Center, Faculdade de Medicina do ABC, Santo André, Brazil
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7
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Cao K, Arthurs C, Atta-Ul A, Millar M, Beltran M, Neuhaus J, Horn LC, Henrique R, Ahmed A, Thrasivoulou C. Quantitative Analysis of Seven New Prostate Cancer Biomarkers and the Potential Future of the 'Biomarker Laboratory'. Diagnostics (Basel) 2018; 8:diagnostics8030049. [PMID: 30060509 PMCID: PMC6163663 DOI: 10.3390/diagnostics8030049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 12/22/2022] Open
Abstract
Prostate cancer is the third highest cause of male mortality in the developed world, with the burden of the disease increasing dramatically with demographic change. There are significant limitations to the current diagnostic regimens and no established effective screening modality. To this end, research has discovered hundreds of potential ‘biomarkers’ that may one day be of use in screening, diagnosis or prognostication. However, the barriers to bringing biomarkers to clinical evaluation and eventually into clinical usage have yet to be realised. This is an operational challenge that requires some new thinking and development of paradigms to increase the efficiency of the laboratory process and add ‘value’ to the clinician. Value comes in various forms, whether it be a process that is seamlessly integrated into the hospital laboratory environment or one that can provide additional ‘information’ for the clinical pathologist in terms of risk profiling. We describe, herein, an efficient and tissue-conserving pipeline that uses Tissue Microarrays in a semi-automated process that could, one day, be integrated into the hospital laboratory domain, using seven putative prostate cancer biomarkers for illustration.
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Affiliation(s)
- Kevin Cao
- Prostate Cancer Research Centre at the Centre for Stem Cells and Regenerative Medicine, King's College London, London WC2R 2LS, UK.
| | - Callum Arthurs
- Prostate Cancer Research Centre at the Centre for Stem Cells and Regenerative Medicine, King's College London, London WC2R 2LS, UK.
| | - Ali Atta-Ul
- Prostate Cancer Research Centre, University College London, London WC1E 6BT, UK.
| | - Michael Millar
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH8 9YL, UK.
| | - Mariana Beltran
- Aquila BioMedical, Nine, Edinburgh BioQuarter, 9 Little France Road, Edinburgh EH16 4UX, UK.
| | - Jochen Neuhaus
- Head of Urology Research Laboratories, University of Leipzig, Department of Urology, Research Laboratory, Liebigstr. 19, Building C, 04103 Leipzig, Germany.
| | - Lars-Christian Horn
- Division of Gynecologic, Breast & Perinatal Pathology, University Hospital Leipzig, Liebigstasse 24 D, 04103 Leipzig, Germany.
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.
- Department of Pathology and Molecular Immunology, Abel Salazar Institute of Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal.
| | - Aamir Ahmed
- Prostate Cancer Research Centre at the Centre for Stem Cells and Regenerative Medicine, King's College London, London WC2R 2LS, UK.
- Prostate Cancer Research Centre, University College London, London WC1E 6BT, UK.
| | - Christopher Thrasivoulou
- Research Department of Cell and Developmental Biology, The Centre for Cell and Molecular Dynamics, Rockefeller Building, University College London, London WC1E 6BT, UK.
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8
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Abstract
PURPOSE OF REVIEW This review will examine the taxonomy of PCa subclasses across disease states, explore the relationship among specific alterations, and highlight current clinical relevance. RECENT FINDINGS Prostate cancer (PCa) is driven by multiple genomic alterations, with distinct patterns and clinical implications. Alterations occurring early in the timeline of the disease define core subtypes of localized, treatment-naive PCa. With time, an increase in number and severity of genomic alterations adds molecular complexity and is associated with progression to metastasis. These later events are not random and are influenced by the underlying subclasses. All the subclasses of localized disease initially respond to androgen deprivation therapy (ADT), but with progression to castrate-resistant PCa (CRPC), mechanisms of resistance against ADT shift the molecular landscape. In CRPC, resistance mechanisms largely define the biology and sub-classification of these cancers, while clinical relevance and opportunities for precision therapy are still being defined.
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Affiliation(s)
- Kaveri Arora
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, Belfer Research Building, BRB 1452, 413 East 69th Street, New York, NY, 10021, USA.,Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Christopher E Barbieri
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, Belfer Research Building, BRB 1452, 413 East 69th Street, New York, NY, 10021, USA. .,Department of Urology, Weill Cornell Medicine, New York, NY, USA. .,Englander Institute for Precision Medicine of Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY, USA.
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9
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Tolkach Y, Kristiansen G. The Heterogeneity of Prostate Cancer: A Practical Approach. Pathobiology 2018; 85:108-116. [PMID: 29393241 DOI: 10.1159/000477852] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/30/2017] [Indexed: 01/12/2023] Open
Abstract
Prostate cancer is a paradigm tumor model for heterogeneity in almost every sense. Its clinical, spatial, and morphological heterogeneity divided by the high-level molecular genetic diversity outline the complexity of this disease in the clinical and research settings. In this review, we summarize the main aspects of prostate cancer heterogeneity at different levels, with special attention given to the spatial heterogeneity within the prostate, and to the standard morphological heterogeneity, with respect to tumor grading and modern classifications. We also cover the complex issue of molecular genetic heterogeneity, discussing it in the context of the current evidence of the genetic characterization of prostate carcinoma; the interpatient, intertumoral (multifocal disease), and intratumoral heterogeneity; tumor clonality; and metastatic disease. Clinical and research implications are summarized and serve to address the most pertinent problems stemming from the extreme heterogeneity of prostate cancer.
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10
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Sedarsky J, Degon M, Srivastava S, Dobi A. Ethnicity and ERG frequency in prostate cancer. Nat Rev Urol 2017; 15:125-131. [PMID: 28872154 DOI: 10.1038/nrurol.2017.140] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Emerging observations emphasize a distinct biology of prostate cancer among men of different ethnicities and races, as demonstrated by remarkable differences in the frequency of ERG oncogenic activation, one of the most common and widely studied prostate cancer driver genes. Worldwide assessment of ERG alterations frequencies show consistent trends, with men of European ancestry having the highest rates of alteration and men of African or Asian ancestries having considerably lower alteration rates. However, data must be interpreted cautiously, owing to variations in assay platforms and specimen types, as well as ethnic and geographical classifications. Many opportunities and challenges remain in assessing cancer-associated molecular alterations at a global level, and these need to be addressed in order to realize the true potential of precision medicine for all cancer patients.
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Affiliation(s)
- Jason Sedarsky
- Urology Service, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, Maryland 20889, USA
| | - Michael Degon
- Urology Service, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, Maryland 20889, USA
| | - Shiv Srivastava
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, 4301 Jones Bridge Rd, Bethesda, Maryland 20814, USA
| | - Albert Dobi
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, 4301 Jones Bridge Rd, Bethesda, Maryland 20814, USA
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11
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Decreased expression of MT1E is a potential biomarker of prostate cancer progression. Oncotarget 2017; 8:61709-61718. [PMID: 28977898 PMCID: PMC5617458 DOI: 10.18632/oncotarget.18683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/22/2017] [Indexed: 11/25/2022] Open
Abstract
Differentiation of indolent and aggressive prostate carcinoma (PCa) at the time of diagnosis is currently one of the major challenges. This study aimed at identification of prognostic biomarkers to aid in predicting biochemical recurrence (BCR) of the disease. Microarray-based gene expression profiling in tissues of 8 BCR and 8 No-BCR cases revealed expression differences of 455 genes, most of which were down-regulated in BCR cases. Eleven genes were selected for validation by real-time PCR in the first PCa cohort (N = 55), while seven of them were further validated in the second, independent, PCa cohort (N = 53). Down-regulation of MT1E (p < 0.001) and GPR52 (p = 0.002) expression and up-regulated levels of EZH2 (p = 0.025) were specific biomarkers of BCR in at least one of the two PCa cohorts, but only MT1E expression retained the independent prognostic value in a multivariate analysis (p < 0.001). DNA methylation analysis (114 PCa and 24 non-cancerous tissues) showed frequent MT1E methylation in PCa (p < 0.001) and was associated (p < 0.010) with the down-regulated expression in one PCa cohort. The results of our study suggest MT1E down-regulation as a potential feature of aggressive PCa.
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12
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Zhang X, Yin X, Shen P, Sun G, Yang Y, Liu J, Chen N, Zeng H. The association between SPINK1 and clinical outcomes in patients with prostate cancer: a systematic review and meta-analysis. Onco Targets Ther 2017; 10:3123-3130. [PMID: 28790846 PMCID: PMC5488756 DOI: 10.2147/ott.s127317] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Evidence of the prognostic role of serine peptidase inhibitor Kazal type 1 (SPINK1) in prostate cancer (PCa) is controversial. The aim of this study was, therefore, to evaluate the association between SPINK1 and clinical outcomes in PCa. Searches were made of PubMed, Medline, Embase, and the China Biology Medicine disc (CBMdisc) up to January 2017. The Newcastle–Ottawa Scale was used to assess the risk of bias of included studies. RevMan software was used to perform meta-analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was employed for assessing the quality of the evidence. Ten studies with 17,161 patients were included in the analysis. Random-effect models were adopted for all outcomes with significant heterogeneities. In patients treated with radical prostatectomy, SPINK1 was associated with biochemical recurrence (BCR) (hazard ratio [HR] =1.41, 95% confidence interval [CI]: 1.01–1.97; P=0.04), but not PCa-specific mortality (HR =0.93, 95% CI: 0.33–2.57; P=0.88), and overall survival (OS) (HR =0.89, 95% CI: 0.58–1.35; P=0.57). In metastatic PCa, SPINK1 was significantly associated with castration-resistant PCa-free survival (HR =3.87, 95% CI: 1.87–8.00; P=0.0003) and OS (HR =2.59, 95% CI: 1.16–5.78; P=0.02). However, the quality of the evidence was very low for all study outcome measures. In conclusion, although SPINK1 was not a predictor of PCa mortality or OS among patients who underwent radical prostatectomy, it may have prognostic value in metastatic PCa.
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Affiliation(s)
| | - Xiaoxue Yin
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | | | | | | | | | - Ni Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hao Zeng
- Department of Urology, Institute of Urology
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Mancarella C, Casanova-Salas I, Calatrava A, García-Flores M, Garofalo C, Grilli A, Rubio-Briones J, Scotlandi K, López-Guerrero JA. Insulin-like growth factor 1 receptor affects the survival of primary prostate cancer patients depending on TMPRSS2-ERG status. BMC Cancer 2017; 17:367. [PMID: 28545426 PMCID: PMC5445474 DOI: 10.1186/s12885-017-3356-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 05/15/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) is characterized by clinical and biological heterogeneity and has differential outcomes and mortality rates. Therefore, it is necessary to identify molecular alterations to define new therapeutic strategies based on the risk of progression. In this study, the prognostic relevance of the insulin-like growth factor (IGF) system was examined in molecular subtypes defined by TMPRSS2-ERG (T2E) gene fusion within a series of patients with primary localized PCa. METHODS A cohort of 270 formalin-fixed and paraffin-embedded (FFPE) primary PCa samples from patients with more than 5 years' follow-up was collected. IGF-1R, IGF-1, IGFBP-3 and INSR expression was analyzed using quantitative RT-PCR. The T2E status and immunohistochemical ERG findings were considered in the analyses. The association with both biochemical and clinical progression-free survival (BPFS and PFS, respectively) was evaluated for the different molecular subtypes using the Kaplan-Meier proportional risk log-rank test and the Cox proportional hazards model. RESULTS An association between IGF-1R overexpression and better BPFS was found in T2E-negative patients (35.3% BPFS, p-value = 0.016). Multivariate analysis demonstrated that IGF-1R expression constitutes an independent variable in T2E-negative patients [HR: 0.41. CI 95% (0.2-0.82), p = 0.013]. These data were confirmed using immunohistochemistry of ERG as subrogate of T2E. High IGF-1 expression correlated with prolonged BPFS and PFS independent of the T2E status. CONCLUSIONS IGF-1R, a reported target of T2E, constitutes an independent factor for good prognosis in T2E-negative PCa. Quantitative evaluation of IGF-1/IGF-1R expression combined with molecular assessment of T2E status or ERG protein expression represents a useful marker for tumor progression in localized PCa.
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Affiliation(s)
- Caterina Mancarella
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy
| | - Irene Casanova-Salas
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8, 46009 Valencia, Spain
| | - Ana Calatrava
- Department of Pathology, Fundación Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8, 46009 Valencia, Spain
| | - Maria García-Flores
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8, 46009 Valencia, Spain
| | - Cecilia Garofalo
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy
| | - Andrea Grilli
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy
| | - José Rubio-Briones
- Department of Urology, Fundación Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8, 46009 Valencia, Spain
| | - Katia Scotlandi
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy
| | - José Antonio López-Guerrero
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, C/ Prof. Beltrán Báguena, 8, 46009 Valencia, Spain
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Liu X, Xue M. Noninvasive Prenatal Diagnosis Significance of ERG Methylation as a Biomarker in Down's Syndrome. Med Sci Monit 2017; 23:398-404. [PMID: 28111453 PMCID: PMC5282964 DOI: 10.12659/msm.898687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Down’s syndrome (DS) is a genetic disease with chromosome abnormality due to the increasing chromosome 21. This study focused on the clinical application value of ERG methylation level in blood of pregnant women as a biomarker in Down’s syndrome. Material/Methods The sham group consisted of 210 nonpregnant women, the positive control group consisted of 33 women with a delivery history of DS fetus, and the negative control group consisted of 60 women with eutocia history. A combination of restriction enzyme digestion experiment and PCR was performed to examine ERG methylation levels, methylation sites, and distribution in blood of pregnant women and in chorion tissues from abortion samples. Gene sequencing was performed to determine the ERG sequence in chromosome 21. Homology between normal tissues and chorion tissues from abortion samples was analyzed with bioinformatics technology. Results ERG methylation in chorion tissues from 210 abortion samples at 8, 9, and 10 weeks gestational age were determined; however, no ERG methylation was determined in blood of pregnant women. Gene sequencing indicated that normal ERG sequence in chromosome 21 was in fetus chorion tissues, and these ERG sequences were aberrantly methylated. Bioinformatics result showed that homology and DNA methylation level was discrepancy in normal tissues and chorion tissues from abortion samples. Conclusions It was worthwhile to use ERG methylation as biomarker in noninvasive prenatal diagnosis, and ERG methylation should be applied with consent of pregnancy and her relatives.
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Affiliation(s)
- Xiangju Liu
- Genetics Diagnostic Lab, Tai'an Maternity and Child Care Hospital, Tai'an, Shandong, China (mainland)
| | - Ming Xue
- Genetics Diagnostic Lab, Tai'an Maternity and Child Care Hospital, Tai'an, Shandong, China (mainland)
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Ding Y, Wu H, Warden C, Steele L, Liu X, van Iterson M, Wu X, Nelson R, Liu Z, Yuan YC, Neuhausen SL. Gene Expression Differences in Prostate Cancers between Young and Old Men. PLoS Genet 2016; 12:e1006477. [PMID: 28027300 PMCID: PMC5189936 DOI: 10.1371/journal.pgen.1006477] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/14/2016] [Indexed: 12/22/2022] Open
Abstract
Prostate cancer incidence is increasing in younger men. We investigated whether men diagnosed with Gleason 7 (3+4) T2 prostate cancer at younger ages (≤ 45 years, young cohort) had different mRNA and miRNA expression profiles than men diagnosed at older ages (71–74 years, older cohort). We identified differentially expressed genes (DEGs) related to tumor-normal differences between the cohorts. Subsequent pathway analysis of DEGs revealed that the young cohort had significantly more pronounced inflammatory and immune responses to tumor development compared to the older cohort. Further supporting a role of inflammation-induced immune-suppression in the development of early-onset prostate cancer, we observed significant up-regulation of CTLA4 and IDO1/TDO2 pathways in tumors of the young cohort. Moreover, over-expression of CTLA4 and IDO1 was significantly associated with biochemical recurrence. Our results provide clues on the mechanisms of tumor development and point to potential biomarkers for early detection and treatment for prostate cancer in young men. The incidence of prostate cancer is increasing in young men, and young men are more likely to develop more aggressive prostate cancers than older men. These findings suggest biological differences between prostate cancers that develop in young men and in older men; yet little data and few studies on men diagnosed under age 50 years exist. In this study, we investigated whether men diagnosed with prostate cancer at young ages (≤ age 45 years) had different gene expression profiles than men diagnosed at older ages (71–74 years). We found that inflammatory and immune-related pathways were up-regulated in the young group as compared to the older group, suggesting fundamental differences in tumor development. Moreover, 21% of the young group, compared to 8% of the older group, had biochemical recurrence of prostate cancer–a surprising result given that both groups were diagnosed in early stages of disease (all T2, Gleason 7 (3+4). The recurrence in the young group was associated with over-expression of two genes involved in immune regulation. After validation in a larger dataset, these may provide clues for potential biomarkers to test for monitoring which young patients are likely to progress.
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Affiliation(s)
- Yuanchun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Huiqing Wu
- Department of Pathology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Charles Warden
- Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Xueli Liu
- Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - M. van Iterson
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Xiwei Wu
- Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Rebecca Nelson
- Department of Pathology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Zheng Liu
- Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Yate-Ching Yuan
- Department of Cellular and Molecular Biology, Beckman Research Institute of City of Hope, Duarte, California, United States of America
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California, United States of America
- * E-mail:
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MUC1 Expression by Immunohistochemistry Is Associated with Adverse Pathologic Features in Prostate Cancer: A Multi-Institutional Study. PLoS One 2016; 11:e0165236. [PMID: 27846218 PMCID: PMC5112958 DOI: 10.1371/journal.pone.0165236] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/16/2016] [Indexed: 12/31/2022] Open
Abstract
Background The uncertainties inherent in clinical measures of prostate cancer (CaP) aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC) predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters. Material and Methods MUC1 IHC was performed on a multi-institutional tissue microarray (TMA) resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test. Results The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS) (HR: 1.24, CI 1.03–1.49, P = 0.02), although not with disease specific survival (DSS, P>0.5). On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS), but was weakly associated with overall survival (OS). Conclusion In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.
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18
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Brooks JD, Wei W, Pollack JR, West RB, Shin JH, Sunwoo JB, Hawley SJ, Auman H, Newcomb LF, Simko J, Hurtado-Coll A, Troyer DA, Carroll PR, Gleave ME, Lin DW, Nelson PS, Thompson IM, True LD, McKenney JK, Feng Z, Fazli L. Loss of Expression of AZGP1 Is Associated With Worse Clinical Outcomes in a Multi-Institutional Radical Prostatectomy Cohort. Prostate 2016; 76:1409-19. [PMID: 27325561 PMCID: PMC5557496 DOI: 10.1002/pros.23225] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Given the uncertainties inherent in clinical measures of prostate cancer aggressiveness, clinically validated tissue biomarkers are needed. We tested whether Alpha-2-Glycoprotein 1, Zinc-Binding (AZGP1) protein levels, measured by immunohistochemistry, and RNA expression, by RNA in situ hybridization (RISH), predict recurrence after radical prostatectomy independent of clinical and pathological parameters. METHODS AZGP1 IHC and RISH were performed on a large multi-institutional tissue microarray resource including 1,275 men with 5 year median follow-up. The relationship between IHC and RISH expression levels was assessed using the Kappa analysis. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazards models and the Log-rank test. RESULTS Absent or weak expression of AZGP1 protein was associated with worse recurrence free survival (RFS), disease specific survival, and overall survival after radical prostatectomy in univariable analysis. AZGP1 protein expression, along with pre-operative serum PSA levels, surgical margin status, seminal vesicle invasion, extracapsular extension, and Gleason score predicted RFS on multivariable analysis. Similarly, absent or low AZGP1 RNA expression by RISH predicted worse RFS after prostatectomy in univariable and multivariable analysis. CONCLUSIONS In our large, rigorously designed validation cohort, loss of AZGP1 expression predicts RFS after radical prostatectomy independent of clinical and pathological variables. Prostate 76:1409-1419, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- James D Brooks
- Department of Urology, Stanford University, Stanford, California.
| | - Wei Wei
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Robert B West
- Department of Pathology, Stanford University, Stanford, California
| | - Jun Ho Shin
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California
| | - John B Sunwoo
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California
| | - Sarah J Hawley
- Canary Foundation, Canary Center at Stanford, Palo Alto, California
| | - Heidi Auman
- Canary Foundation, Canary Center at Stanford, Palo Alto, California
| | - Lisa F Newcomb
- Department of Urology, University of Washington Medical Center, Seattle, Washington
| | - Jeff Simko
- Department of Pathology, University of California San Francisco, San Francisco, California
| | - Antonio Hurtado-Coll
- Department of Urologic Sciences and Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Dean A Troyer
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Eastern Virginia Medical School, Pathology and Microbiology and Molecular Biology, Norfolk, Virginia
| | - Peter R Carroll
- Department of Urology, University of California San Francisco, San Francisco, California
| | - Martin E Gleave
- Department of Urologic Sciences and Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Daniel W Lin
- Department of Urology, University of Washington Medical Center, Seattle, Washington
| | - Peter S Nelson
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ian M Thompson
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Lawrence D True
- Department of Pathology, University of Washington Medical Center, Seattle, Washington
| | | | - Ziding Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ladan Fazli
- Department of Urologic Sciences and Vancouver Prostate Centre, Vancouver, British Columbia, Canada
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Huang KC, Evans A, Donnelly B, Bismar TA. SPINK1 Overexpression in Localized Prostate Cancer: a Rare Event Inversely Associated with ERG Expression and Exclusive of Homozygous PTEN Deletion. Pathol Oncol Res 2016; 23:399-407. [PMID: 27738792 DOI: 10.1007/s12253-016-0119-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 09/28/2016] [Indexed: 12/17/2022]
Abstract
SPINK1 is proposed as potential prognostic marker in prostate cancer (PCA). However, its relation to PTEN and ERG in localized PCA remains unclear. The study population consisted of two independent cohorts of men treated by radical prostatectomy for localized PCA (discovery n = 218 and validation n = 129). Patterns of association between SPINK1 and each of ERG and PTEN were evaluated by immunohistochemistry and fluorescence in situ hybridization. Associations between SPINK1 expression and various pathologic parameters and clinical outcome were also investigated. SPINK1 was expressed in 15.3 % and 10.9 % of cases in the discovery and validation cohort, respectively. SPINK expression was observed in 5.56 % of high-grade prostatic intraepithelial neoplasia and 1.1 % of adjacent morphologically benign prostatic glands. SPINK1 and ERG expression were almost exclusive, with only 1.0 % of the cases co-expressing both in the same core sample. SPINK1 interfocal and within-core heterogeneity was noted in 29.2 % and 64.6 % of cases, respectively. SPINK1 expression was not significantly associated with PTEN deletion in the two cohorts (p = 0.871 for discovery cohort and p = 0.293 for validation cohort). While SPINK1 expression did occur with hemizygous PTEN deletion, there was a complete absence of SPINK1 expression in PCA showing homozygous PTEN deletion, which was confirmed in the validation cohort (p = 0.02). Despite SPINK1's association with higher Gleason score (>7) (p = 0.02), it was not associated with other pathological parameters or biochemical recurrence post-radical prostatectomy. We documented absolute exclusivity between SPINK1 overexpression and homozygous PTEN deletion in localized PCA. SPINK1 and ERG expressions are exclusive events in PCA. SPINK1 is not of added prognostic value in localized PCA.
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Affiliation(s)
- Kuo-Cheng Huang
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, 7007, 14sth st sw, Calgary, AB, T2V 1P9, Canada
| | - Andrew Evans
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Bryan Donnelly
- Department of Urology, University of Calgary, Calgary, AB, Canada
- The Prostate Cancer Center, Calgary, AB, Canada
| | - Tarek A Bismar
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, 7007, 14sth st sw, Calgary, AB, T2V 1P9, Canada.
- Departments of Oncology, Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada.
- Southern Alberta Cancer Institute and Tom Baker Cancer Center, Calgary, AB, Canada.
- The Prostate Cancer Center, Calgary, AB, Canada.
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Tonry CL, Leacy E, Raso C, Finn SP, Armstrong J, Pennington SR. The Role of Proteomics in Biomarker Development for Improved Patient Diagnosis and Clinical Decision Making in Prostate Cancer. Diagnostics (Basel) 2016; 6:E27. [PMID: 27438858 PMCID: PMC5039561 DOI: 10.3390/diagnostics6030027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/28/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023] Open
Abstract
Prostate Cancer (PCa) is the second most commonly diagnosed cancer in men worldwide. Although increased expression of prostate-specific antigen (PSA) is an effective indicator for the recurrence of PCa, its intended use as a screening marker for PCa is of considerable controversy. Recent research efforts in the field of PCa biomarkers have focused on the identification of tissue and fluid-based biomarkers that would be better able to stratify those individuals diagnosed with PCa who (i) might best receive no treatment (active surveillance of the disease); (ii) would benefit from existing treatments; or (iii) those who are likely to succumb to disease recurrence and/or have aggressive disease. The growing demand for better prostate cancer biomarkers has coincided with the development of improved discovery and evaluation technologies for multiplexed measurement of proteins in bio-fluids and tissues. This review aims to (i) provide an overview of these technologies as well as describe some of the candidate PCa protein biomarkers that have been discovered using them; (ii) address some of the general limitations in the clinical evaluation and validation of protein biomarkers; and (iii) make recommendations for strategies that could be adopted to improve the successful development of protein biomarkers to deliver improvements in personalized PCa patient decision making.
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Affiliation(s)
- Claire L Tonry
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Emma Leacy
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Cinzia Raso
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Stephen P Finn
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | | | - Stephen R Pennington
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
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21
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Lotan TL, Wei W, Morais CL, Hawley ST, Fazli L, Hurtado-Coll A, Troyer D, McKenney JK, Simko J, Carroll PR, Gleave M, Lance R, Lin DW, Nelson PS, Thompson IM, True LD, Feng Z, Brooks JD. PTEN Loss as Determined by Clinical-grade Immunohistochemistry Assay Is Associated with Worse Recurrence-free Survival in Prostate Cancer. Eur Urol Focus 2016; 2:180-188. [PMID: 27617307 DOI: 10.1016/j.euf.2015.07.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND PTEN is the most commonly deleted tumor suppressor gene in primary prostate cancer (PCa) and its loss is associated with poor clinical outcomes and ERG gene rearrangement. OBJECTIVE We tested whether PTEN loss is associated with shorter recurrence-free survival (RFS) in surgically treated PCa patients with known ERG status. DESIGN SETTING AND PARTICIPANTS A genetically validated, automated PTEN immunohistochemistry (IHC) protocol was used for 1275 primary prostate tumors from the Canary Foundation retrospective PCa tissue microarray cohort to assess homogeneous (in all tumor tissue sampled) or heterogeneous (in a subset of tumor tissue sampled) PTEN loss. ERG status as determined by a genetically validated IHC assay was available for a subset of 938 tumors. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Associations between PTEN and ERG status were assessed using Fisher's exact test. Kaplan-Meier and multivariate weighted Cox proportional models for RFS were constructed. RESULTS AND LIMITATIONS When compared to intact PTEN, homogeneous (hazard ratio [HR] 1.66, p = 0.001) but not heterogeneous (HR 1.24, p = 0.14) PTEN loss was significantly associated with shorter RFS in multivariate models. Among ERG-positive tumors, homogeneous (HR 3.07, p < 0.0001) but not heterogeneous (HR 1.46, p = 0.10) PTEN loss was significantly associated with shorter RFS. Among ERG-negative tumors, PTEN did not reach significance for inclusion in the final multivariate models. The interaction term for PTEN and ERG status with respect to RFS did not reach statistical significance (p = 0.11) for the current sample size. CONCLUSIONS These data suggest that PTEN is a useful prognostic biomarker and that there is no statistically significant interaction between PTEN and ERG status for RFS. PATIENT SUMMARY We found that loss of the PTEN tumor suppressor gene in prostate tumors as assessed by tissue staining is correlated with shorter time to prostate cancer recurrence after radical prostatectomy.
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Affiliation(s)
- Tamara L Lotan
- Pathology Department, Johns Hopkins School of Medicine, Baltimore, MD, USA; Oncology Department, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wei Wei
- MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos L Morais
- Pathology Department, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Ladan Fazli
- Vancouver Prostate Centre, Vancouver, BC, Canada
| | | | - Dean Troyer
- Pathology Department, Eastern Virginia Medical School, Norfolk, VA, USA; Urology Department, Eastern Virginia Medical School, Norfolk, VA, USA
| | | | - Jeffrey Simko
- Pathology Department, University of California-San Francisco, San Francisco, CA, USA; Urology Department, University of California-San Francisco, San Francisco, CA, USA
| | - Peter R Carroll
- Urology Department, University of California-San Francisco, San Francisco, CA, USA
| | | | - Raymond Lance
- Urology Department, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Daniel W Lin
- Urology Department, University of Washington, Seattle, WA, USA
| | - Peter S Nelson
- Oncology Department, University of Washington, Seattle, WA, USA; Pathology Department, University of Washington, Seattle, WA, USA
| | - Ian M Thompson
- Urology Department, University of Texas Health Science Center, San Antonio, TX, USA
| | - Lawrence D True
- Pathology Department, University of California-San Francisco, San Francisco, CA, USA
| | | | - James D Brooks
- Urology Department, Stanford University School of Medicine, Stanford, CA, USA
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22
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Fontugne J, Davis K, Palanisamy N, Udager A, Mehra R, McDaniel AS, Siddiqui J, Rubin MA, Mosquera JM, Tomlins SA. Clonal evaluation of prostate cancer foci in biopsies with discontinuous tumor involvement by dual ERG/SPINK1 immunohistochemistry. Mod Pathol 2016; 29:157-65. [PMID: 26743468 PMCID: PMC4732921 DOI: 10.1038/modpathol.2015.148] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/06/2015] [Accepted: 11/07/2015] [Indexed: 12/16/2022]
Abstract
The presence of two or more prostate cancer foci separated by intervening benign tissue in a single core is a well-recognized finding on prostate biopsy. Cancer involvement can be measured by including intervening benign tissue or only including the actual cancer involved area. Importantly, this parameter is a common enrollment criterion for active surveillance protocols. We hypothesized that spatially distinct prostate cancer foci in biopsies may arise from separate clones, impacting cancer involvement assessment. Hence, we used dual ERG/SPINK1 immunohistochemistry to determine the frequency of separate clones-when separate tumor foci showed discordant ERG and/or SPINK1 status-in discontinuously involved prostate biopsy cores from two academic institutions. In our cohort of 97 prostate biopsy cores with spatially discrete tumor foci (from 80 patients), discontinuous cancer involvement including intervening tissue ranged from 20 to 100% and Gleason scores ranged from 6 to 9. Twenty-four (25%) of 97 discontinuously involved cores harbored clonally distinct cancer foci by discordant ERG and/or SPINK1 expression status: 58% (14/24) had one ERG(+) focus, and one ERG(-)/SPINK1(-) focus; 29% (7/24) had one SPINK1(+) focus and one ERG(-)/SPINK1(-) focus; and 13% (3/24) had one ERG(+) focus and one SPINK1(+) focus. ERG and SPINK1 overexpression were mutually exclusive in all tumor foci. In summary, our results show that ~25% of discontinuously involved prostate biopsy cores showed tumor foci with discordant ERG/SPINK1 status, consistent with multiclonal disease. The relatively frequent presence of multiclonality in discontinuously involved prostate biopsy cores warrants studies on the potential clinical impact of clonality assessment, particularly in cases where tumor volume in a discontinuous core may impact active surveillance eligibility.
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Affiliation(s)
- Jacqueline Fontugne
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Kristina Davis
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Aaron Udager
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew S. McDaniel
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mark A. Rubin
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Juan Miguel Mosquera
- Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY, USA,Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian, New York, NY, USA
| | - Scott A. Tomlins
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA,Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
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Huang KC, Bégin LR, Palanisamy N, Donnelly B, Bismar TA. SPINK1 expression in relation to PTEN and ERG in matched primary and lymph node metastatic prostate cancer: Implications for biomarker development. Urol Oncol 2015; 34:235.e1-10. [PMID: 26725250 DOI: 10.1016/j.urolonc.2015.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/04/2015] [Accepted: 11/14/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND SPINK1, ERG, and PTEN are proposed prognostic biomarkers in prostate cancer (PCA). However, their relations and patterns of expression in primary and metastatic lymph node (LN) PCAs are not fully explored. METHODS A tissue microarray of matched primary PCA and LN metastasis was constructed from 36 patients. SPINK1, ERG, and PTEN expression statuses were assessed by immunohistochemistry and correlated with each other. RESULTS SPINK1 and ERG were expressed in 25% and 42.7% of primary PCA cases, respectively. PTEN loss of any degree was observed in 91.7% of primary PCA cases, with 54.2% showing complete loss. In primary PCA, 12.5% of the cases showed SPINK1+/ERG-phenotype, 16.7% showed SPINK1+/ERG+phenotype, 25.0% showed SPINK1-/ERG+phenotype, and 45.8% showed SPINK1-/ERG-phenotype. All PCAs with expression of either SPINK1 or ERG also exhibited PTEN loss, whereas PCA without PTEN loss (2 cases) expressed neither SPINK1 nor ERG. In primary PCA, evaluation of combined ERG and SPINK1 status, but not SPINK1 individually, was associated with a significant difference in proportion of Gleason patterns (P = 0.013), with the SPINK1+/ERG+and SPINK1-/ERG-phenotypes represented more in Gleason pattern>7 PCAs. In LN metastases, the overall SPINK1 protein expression frequency was significantly lower (6.5% of cases) compared with primary PCA (P = 0.03). Only 16.7% of cases with positive SPINK1 expression in primary PCA maintained expression in LN metastases. The down-regulated SPINK1 expression in LN was primarily because of a reduction in the SPINK1+/ERG+PCA subpopulation to 3.5% of cases (P = 0.16 compared with primary PCA). The frequencies of ERG expression and PTEN loss were relatively stable in primary PCA and LN metastases. CONCLUSION SPINK1 expression is dynamically regulated with up-regulation in primary sites of nodal metastatic PCA and down-regulation in LN metastases. The increased SPINK1 expression in primary site of nodal metastatic PCA is secondary to an increased frequency of SPINK1+/ERG+tumors. In primary PCAs, the SPINK1+/ERG+phenotype is associated with higher Gleason grade, suggesting that this phenotype may mark a more aggressive PCA subpopulation with higher risk of LN metastases.
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Affiliation(s)
- Kuo-Cheng Huang
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Louis R Bégin
- Division of Anatomic Pathology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Nallasivam Palanisamy
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI
| | - Bryan Donnelly
- Department of Urology, University of Calgary, Calgary, Alberta, Canada; The Prostate Cancer Center, Calgary, Alberta, Canada
| | - Tarek A Bismar
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada; The Prostate Cancer Center, Calgary, Alberta, Canada; Departments of Oncology, Biochemistry and Molecular Biology, Calgary, Alberta, Canada; Southern Alberta Cancer Institute and Tom Baker Cancer Center, Calgary, Alberta, Canada.
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