Does the Inverse Immunoexpression Pattern of Nestin and Androgen Receptor Predict Treatment Failure in Patients with Prostatic Adenocarcinoma?
J Jani, C Cohen, AO Osunkoya. Emory University School of Medicine, Atlanta, GA
Background: Prostate epithelial stem cells are primed by the urogenital mesenchyme to initiate bud formation and branching morphogenesis, ultimately culminating in glandular structures composed of luminal, basal and neuroendocrine cells. The true identity of these stem cells is however not yet fully understood. Androgens are critical to prostate organogenesis and play a major role in normal prostate function and the development of prostate cancer (PCa). The goal of this study is to correlate the expression of stem cell marker nestin with androgen receptor (AR) to potentially predict the treatment failure rate in cases of androgen independent tumors and the possibility of future targeted therapy.
Design: Sixty patients treated with radical prostatectomy between 1996 and 2007, for localized PCa, were studied. The patient population was divided into 4 quartiles of 15 cases each based on Gleason score (3+3=6, 3+4=7, 4+4 =8 and 4+5=9). A tissue microarray was constructed and immunohistochemical stains were performed for nestin and AR.
|Gleason score 3+3=6, 3+4=7 (30 cases)||Gleason score 4+4=8, 4+5=9 (30 cases)|
|Nestin +ve cases (%)||2 (7) 3+ diffuse||20 (67) 3+ diffuse|
|AR +ve cases (%)||30 (100) diffuse 3+||30 (100) focal 1+|
|+ve Lymph node metastasis (%)||0 (0)||9 (30)|
|+ve Angiolymphatic invasion (%)||0 (0)||9 (30)|
|+ve Extra Prostatic extension (%)||0 (0)||2 (7)|
|+ve Bone metastasis (%)||0 (0)||2 (7)|