Oncologic results associated with combined PTEN loss and ERG expression in prostate cancer patients after radical prostatectomy

Charalampos Fragkoulis, Georgios Stathouros, Christos Karabogias, Akrivi Kostopoulou, Theodosia Choreutaki, Konstantinos Ntoumas


Introduction: Prostate cancer is one of the leading causes of cancer mortality in Europe displaying a variety of clinical behavior from tumors of low clinical significance to highly aggressive tumors. There is an increasing interest in identifying molecular pathways and genes which can be used as prognostic factors. The purpose of this study is to evaluate PTEN loss and ERG expression on oncologic results in patients who underwent radical prostatectomy as treatment for localized prostate cancer.

Methods: We analyzed data from 68 patients who underwent radical prostatectomy for localized prostate cancer in our department the last year. In all patients we assessed PTEN and TMPRSS - 2 ERG expression by immunohistochemistry methods. Patients were divided into four groups according to PTEN and TMPRSS - 2 combined expression and oncologic results were compared accordingly.

Results: This study support data showing that PTEN loss is an unfavourable prognostic marker. Furthermore, the worst oncologic results following radical prostatectomy were present in the group of patients who had PTEN deletion without expression of TMPRSS - 2 ERG fusion protein. Loss of PTEN expression combined with non expression of TMPRSS - 2 ERG fusion was associated with higher rates of positive surgical margins (17.6%), higher rates of Gleason Score 8 or 9 (8.8%) and more frequent rates of seminal vesicles invasion (7.4%).


Σκοπός: Ο καρκίνος προστάτη αποτελεί μία από τις βασικότερες αιτίες θανάτου από καρκίνο στην Ευρώπη. Παρουσιάζεται με εύρος που εκτείνεται από όγκους χαμηλής κλινικής σημασίας έως πολύ επιθετικούς όγκους. Τα τελευταία χρόνια υπάρχει αυξανόμενο ενδιαφέρων για την ανεύρεση μοριακών μηχανισμών που μπορεί να χρησιμοποιηθούν και ως προγνωστικοί παράγοντες. Σκοπός αυτής της μελέτης είναι η επίδραση της συνδυασμένης απώλειας του PTEN και έκφρασης της ERG στα ογκολογικά αποτελέσματα ασθενών με καρκίνο προστάτη που υποβλήθηκαν σε ριζική προστατεκτομή.

Μέθοδος: Αναλύθηκαν δεδομένα 68 ασθενών που υποβλήθηκαν σε ριζική προστατεκτομή στο τμήμα μας το τελευταίο έτος. Σε όλους του ασθενείς αξιολογήθηκε η έκφραση του PTEN και της TMPRSS - 2 ERG πρωτεΐνης με ανοσοϊστοχημεία.

Αποτελέσματα: Η μελέτη υποστηρίζει τα δεδομένα της βιβλιογραφίας που δείχνουν ότι η απώλεια του PTEN είναι ένας επιβαρυντικός προγνωστικός παράγοντας. Επιπλέον, τα πιο επιβαρυντικά ογκολογικά αποτελέσματα βρέθηκαν στην ομάδα που παρουσίαζε απώλεια του PTEN χωρίς όμως παράλληλη έκφραση της TMPRSS - 2 ERG πρωτεΐνης καθώς οι ασθενείς αυτής της ομάδας παρουσίασαν υψηλότερα ποσοστά θετικών χειρουργικών ορίων (17.6%), διήθησης σπερματοδόχων κύστεων (7.4%) καθώς και Gleason Score 8 ή 9 (8.8%).


PTEN; TMPRSS2 - ERG; prostate cancer; radical prostatectomy; καρκίνος προστάτη, ριζική προστατεκτομή

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DOI: http://dx.doi.org/10.19264/hj.v27i4.102