Prognostic Value of Endocan in Prostate Cancer: Clinicopathologic Association between Serum Endocan Levels and Biochemical Recurrence after Radical Prostatectomy

The Potential of Extracellular Matrix- and Integrin Adhesion Complex-Related Molecules for Prostate Cancer Biomarker Discovery

Prostate cancer is among the top five cancer types according to incidence and mortality. One of the main obstacles in prostate cancer management is the inability to foresee its course, which ranges from slow growth throughout years that requires minimum or no intervention to highly aggressive disease that spreads quickly and resists treatment. Therefore, it is not surprising that numerous studies have attempted to find biomarkers of prostate cancer occurrence, risk stratification, therapy response, and patient outcome. However, only a few prostate cancer biomarkers are used in clinics, which shows how difficult it is to find a novel biomarker. Cell adhesion to the extracellular matrix (ECM) through integrins is among the essential processes that govern its fate. Upon activation and ligation, integrins form multi-protein intracellular structures called integrin adhesion complexes (IACs). In this review article, the focus is put on the biomarker potential of the ECM- and IAC-related molecules stemming from both body fluids and prostate cancer tissue. The processes that they are involved in, such as tumor stiffening, bone turnover, and communication via exosomes, and their biomarker potential are also reviewed.

Endocan: A novel biomarker of endothelial dysfunction in depression?

Endocan is a proteoglycan secreted from endothelium upon endothelial damage. Since depression is associated with higher inflammation and oxidative stress to the vascular endothelium, endothelial dysfunction is prevalent and it is one of the responsible mechanisms for increased cardiovascular morbidity and mortality in depressive disorders. This study aimed to investigate endocan levels in patients with depression (either bipolar or unipolar) and healthy controls to evaluate the projected endothelial injury. We included nonsmoker patients without comorbid inflammatory conditions: 31 with Bipolar Disorder Depression (BDD), 30 with Major Depressive Disorder (MDD) and 25 healthy controls (HC). The severity of depression was assessed with the Hamilton Depression Rating Scale (HDRS). Ultimately, serum endocan levels were significantly higher in patients with BDD than in patients with MDD (p < .000) and HCs (p < .000). Also, patients with MDD had significantly higher endocan levels than HCs (p < .000). The AUC value for the endocan to differentiate patients with depression from controls was 0.990 (95% CI: 0.971-1.000; p < .001) with sensitivity and specificity of 98.4 and 100%, respectively, and an optimal cut-off value of 316.92 ng/L. Serum endocan levels showed a mild positive correlation with HDRS scores (r = 0.372, p = .039) in the BDD group but not in the MDD group (r = -0.242, p = .20). Patients with BDD had higher endocan levels than MDD; this finding, while preliminary, could be an implication of higher endothelial dysfunction in BDD.

Endocan in Acute Leukemia: Current Knowledge and Future Perspectives

Endocan is a soluble dermatan sulfate proteoglycan expressed by endothelial cells and detected in serum/plasma. Its expression is increased in tumors/tumor vessels in several human malignancies, and high expression (high serum/plasma levels or tumor levels) has an adverse prognostic impact in several malignancies. The p14 endocan degradation product can also be detected in serum/plasma, but previous clinical studies as well as previously unpublished results presented in this review suggest that endocan and p14 endocan fragment levels reflect different biological characteristics, and the endocan levels seem to reflect the disease heterogeneity in acute leukemia better than the p14 fragment levels. Furthermore, decreased systemic endocan levels in previously immunocompetent sepsis patients are associated with later severe respiratory complications, but it is not known whether this is true also for immunocompromised acute leukemia patients. Finally, endocan is associated with increased early nonrelapse mortality in (acute leukemia) patients receiving allogeneic stem cell transplantation, and this adverse prognostic impact seems to be independent of the adverse impact of excessive fluid overload. Systemic endocan levels may also become important to predict cytokine release syndrome after immunotherapy/haploidentical transplantation, and in the long-term follow-up of acute leukemia survivors with regard to cardiovascular risk. Therapeutic targeting of endocan is now possible, and the possible role of endocan in acute leukemia should be further investigated to clarify whether the therapeutic strategy should also be considered.

Proteoglycan Endocan: A multifaceted therapeutic target in Cancer

Endocan is known to be a circulating dermatan sulfate proteoglycan that regulates endothelial cell function. Dysregulation of endocan expression is observed not only in the tumor vasculature but also in cancer cells. Accumulating evidence has revealed that disordered endocan facilitates cancer progression via enhancing cancer cell proliferation, cell mobility, and cancer stemness properties. Recently, various interacting proteins and diverse subcellular localizations of endocan were identified in cancer cells. Herein, we summarize the application of endocan in cancer diagnoses and prognoses using serum and tumor specimens. We further discuss that the aberrant molecular characteristics of endocan may be due to the mislocalization of endocan in cancer cells. Defining the specific cellular roles of endocan will provide a promising diagnostic factor and therapeutic target for cancer patients.

Diagnostic and Prognostic Value of Serum Endocan Levels in Patients With COVID-19

We aimed to evaluate whether there was a relationship between endocan (human endothelial cell-specific molecule-1) levels and disease prognosis in patients who presented to the emergency department with coronavirus disease 2019 (COVID-19). A total of 60 patients with COVID-19 who were hospitalized from the emergency department to clinical wards and a control group consisting of healthy adult individuals (n = 28), were included in the study. The majority (93.3%) of the patients were discharged after recovery; 6.7% died. The median endocan value was 243.5 ng/mL in the patient group versus 201.5 ng/mL in the control group (P = .002). The median endocan level was 240.5 ng/mL in those discharged with recovery and 558 ng/mL in those who died (P = .001). There was no significant relationship in hospitalization duration, sex, tomography findings, and clinical outcomes. A 202 ng/mL serum endocan level had 86.7% sensitivity and 50% specificity for COVID-19. Serum endocan levels may be a useful biomarker both for the diagnosis of COVID-19 and to predict mortality.

Targeting Endothelial Cell-Specific Molecule 1 Protein in Cancer: A Promising Therapeutic Approach

Despite the dramatic advances in cancer research in the past few years, effective therapeutic strategies are urgently needed. Endothelial cell-specific molecule 1 (ESM-1), a soluble dermatan sulfate proteoglycan, also known as endocan, serves as a diagnostic and prognostic indicator due to its aberrant expression under pathological conditions, including cancer, sepsis, kidney diseases, and cardiovascular disease. Significantly, ESM-1 can promote cancer progression and metastasis through the regulation of tumor cell proliferation, migration, invasion, and drug resistant. In addition, ESM-1 is involved in the tumor microenvironment, containing inflammation, angiogenesis, and lymph angiogenesis. This article reviews the molecular and biological characteristics of ESM-1 in cancer, the underlying mechanisms, the currently clinical and pre-clinical applications, and potential therapeutic strategies. Herein, we propose that ESM-1 is a new therapeutic target for cancer therapy.

Clinical Potential of Circulating Tumor Cells in Colorectal Cancer: A Prospective Study

Circulating tumor cells (CTCs) in the blood have been used as diagnostic markers in patients with colorectal cancer (CRC). In this study, we evaluated a CTC detection system based on cell size to assess CTCs and their potential as early diagnostic and prognostic biomarkers for CRC.

ESM-1: A Novel Tumor Biomaker and its Research Advances

Background:

Cancer kills nearly 9,000,000 people worldwide, and its mortality was reported up to 28% in the past decade. Few available tumor markers have been known to help early stage diagnosis. In this study, Endocan was taken as a novel tumor marker, which has been found in many cancers related to cancer cell proliferation, neoangiogenesis, etc.

Methods:

Studies on Endocan and its correlation with cancer were reviewed, and key points of meaningful studies on the structure, pathways and targeted agents of Endocan were drawn.

Results:

Endocan leads to tumorigenesis and promotes tumor cells proliferation via HGF/SF signal transmission pathway, suppresses tumor cells apoptosis via NF-κB signaling pathway and promotes angiogenesis within tumors via VEGF and HIF pathway. Medicine suppressing the expression of Endocan could prevent tumorigenesis and even improve survival rate of mice with tumor significantly.

Conclusion:

Endocan is capable of promoting prognosis of cancer patients. Moreover, Endocan is supposed to a potential target of tumor-targeted therapy.

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

BACKGROUND

While a number of studies indicate tobacco smoking has a detrimental impact on survival and recurrence after a prostate cancer diagnosis, there has been no quantitative review of this literature and it is unclear whether tobacco smoking affects clinical populations differentially. We conducted a systematic review and meta-analysis to investigate the associations between tobacco smoking and overall (OM) and prostate cancer-specific (PSM) mortality and recurrence after a prostate cancer diagnosis.

METHODS

EMBASE and ISI Web of Science were searched for English-language studies, published up to August 17, 2017, which conducted a survival analysis to estimate the association between tobacco smoking and OM, PSM and/or recurrence. A random-effects meta-analysis was conducted to estimate the summary hazard ratios (HRs) for the associations between tobacco smoking and the three outcomes.

RESULTS

A total of 28 studies met the inclusion criteria. The results of the primary meta-analysis indicate current smokers have significantly poorer overall survival (Summary HR = 1.96, 95% CI = 1.69, 2.28), prostate cancer-specific survival (Summary HR = 1.79, 95% CI = 1.47, 2.20) and recurrence-free survival (Summary HR = 1.48, 95% CI = 1.28, 1.72) than never smokers. Similar results were found in population-based studies and in studies conducted in specific clinical populations.

CONCLUSIONS

The results of this systematic review and meta-analysis indicate that tobacco smoking at prostate cancer diagnosis is associated with a significantly increased risk of overall mortality, prostate-cancer specific mortality and recurrence. We recommend future studies collect more detailed information about tobacco smoking to further understanding of the association between tobacco smoking and PCa prognosis. In addition, further research should concentrate on the impact of smoking cessation post-diagnosis and post-treatment on prognosis, and the feasibility and effectiveness of smoking cessation programs.