Abstract

BackgroundThe identification of additional prognostic markers to improve risk stratification and to avoid overtreatment is one of the most urgent clinical needs in prostate cancer (PCa). MicroRNAs, being important regulators of gene expression, are promising biomarkers in various cancer entities, though the impact as prognostic predictors in PCa is poorly understood. The aim of this study was to identify specific miRNAs as potential prognostic markers in high-risk PCa and to validate their clinical impact.Methodology and Principal FindingsWe performed miRNA-microarray analysis in a high-risk PCa study group selected by their clinical outcome (clinical progression free survival (CPFS) vs. clinical failure (CF)). We identified seven candidate miRNAs (let-7a/b/c, miR-515-3p/5p, -181b, -146b, and -361) that showed differential expression between both groups. Further qRT-PCR analysis revealed down-regulation of members of the let-7 family in the majority of a large, well-characterized high-risk PCa cohort (n = 98). Expression of let-7a/b/and -c was correlated to clinical outcome parameters of this group. While let-7a showed no association or correlation with clinical relevant data, let-7b and let-7c were associated with CF in PCa patients and functioned partially as independent prognostic marker. Validation of the data using an independent high-risk study cohort revealed that let-7b, but not let-7c, has impact as an independent prognostic marker for BCR and CF. Furthermore, we identified HMGA1, a non-histone protein, as a new target of let-7b and found correlation of let-7b down-regulation with HMGA1 over-expression in primary PCa samples.ConclusionOur findings define a distinct miRNA expression profile in PCa cases with early CF and identified let-7b as prognostic biomarker in high-risk PCa. This study highlights the importance of let-7b as tumor suppressor miRNA in high-risk PCa and presents a basis to improve individual therapy for high-risk PCa patients.

Highlights

  • Prostate cancer (PCa) is the most common malignancy among men in Europe, with an estimated incidence of 345,900 in 2006 [1]

  • High-risk prostate cancer (PCa) cohorts show much better than expected outcomes, they still represent an ideal group to identify factors correlated with the lethal disease

  • Our results demonstrate that high-risk PCa is characterized by a specific miRNA profile and that individual let-7 family members are promising prognostic markers in this patient group

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Summary

Introduction

Prostate cancer (PCa) is the most common malignancy among men in Europe, with an estimated incidence of 345,900 in 2006 [1]. Even men with high-risk PCa (PSA .20 ng/ml and/or biopsy Gleason Score $8 and/or clinical stage $ T3) represent a heterogeneous group of patients. New prognostic biomarkers are urgently needed to better sub-stratify risk groups, identify the lethal disease, eventually avoid overtreatment, and improve individual therapy. The identification of prognostic markers, especially for the lethal disease, is hardly possible in an unselected PCa collective. High-risk PCa cohorts show much better than expected outcomes, they still represent an ideal group to identify factors correlated with the lethal disease. The identification of additional prognostic markers to improve risk stratification and to avoid overtreatment is one of the most urgent clinical needs in prostate cancer (PCa). The aim of this study was to identify specific miRNAs as potential prognostic markers in high-risk PCa and to validate their clinical impact

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