Abstract
BackgroundThe purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy.MethodsPeriostin (POSTN) expression in prostate cancer (PCa) and in normal specimens was evaluated in 90 patients by an immuno-reactive score(IRS) based on the intensity of immunostaining and on the quantity of stained cells. The t-test was applied to compare IRS values in cancer specimens to values in normal specimens. Pearson’s test was used to correlate POSTN expression to clinical pathologic features. PSA progression-free and survival curves were constructed by the Kaplan–Meier method and compared using the log-rank test. Multi-parametric models were constructed according to the Cox technique adding all the covariates predicting for either PSA progression or death into the models after univariate analysis.ResultsBoth stromal and epithelial POSTN expression were significantly increased in tumor tissues. In particular, we found stromal expression to be significantly higher than epithelial expression as compared to normal tissues (p<0.000 and p=0.001).A significant correlation between POSTN epithelial expression and extra-prostatic extension was found (p=0.03). While high stromal expression was significantly associated with shorter survival (p=0.008), a low epithelial score significantly correlated with shorter PSA-free survival (p=0.04), suggesting that POSTN plays an apparently opposing biological role depending on its compartmentalization.Regardless of the mechanism that is involved, patients showing both high stromal and low epithelial expression made up a subgroup with a very bleak prognosis.ConclusionsAlthough requiring further validation through larger studies, our findings show that POSTN might represent a novel prognostic marker for PCa.
Highlights
The purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy
Prostate cancer (PCa) has become the most common malignancy among men in most Western countries [1]. Even when this tumor is apparently confined to the prostate, it encompasses a broad spectrum of diseases, some of which are characterized by extremely indolent behavior and others by very poor outcome
In the present study we investigated POSTN expression in PCa tissue specimens and in normal peritumoral specimens in order to confirm previous findings and to evaluate the putative prognostic value of POSTN as a function of its compartmentalization
Summary
The purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy. Prostate cancer (PCa) has become the most common malignancy among men in most Western countries [1] Even when this tumor is apparently confined to the prostate, it encompasses a broad spectrum of diseases, some of which are characterized by extremely indolent behavior and others by very poor outcome. Among patients who are treated with radical prostatectomy, the most commonly used parameters for defining prognosis and choosing the right candidates for adjuvant local irradiation or systemic treatments include tumor volume and pathological grade and status of surgical margins, seminal vesicles and pelvic nodes [2]. Tumor grade scoring methods can result in significant inter-observer variations, when defining intermediate tumor grades [4,5]. This applies to the old Gleason scoring method.
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