Abstract
Extracellular vesicles (EVs) may play an important role in cancer development and progression. We aimed to investigate the prognostic potential of prostate-specific EVs in prostate cancer (PCa) patients. Plasma and prostate tissue were collected from patients who underwent surgery for PCa (n = 82) or benign prostatic hyperplasia (BPH, n = 28). To analyze the quantity of EVs in prostate, we performed transmission electron microscopy (TEM), immuno-TEM with CD63 and prostate-specific membrane antigen (PSMA), and immunofluorescence staining. After EV isolation from plasma, CD63 and PSMA concentration was measured using ELISA kits. PSMA-positive areas in prostate differed in patients with BPH, and low-, intermediate-, and high-risk PCa (2.4, 8.2, 17.5, 26.5%, p < 0.001). Plasma PSMA-positive EV concentration differed in patients with BPH, and low-, intermediate-, and high-risk PCa (21.9, 43.4, 49.2, 59.9 ng/mL, p < 0.001), and ROC curve analysis indicated that plasma PSMA-positive EV concentration differentiated PCa from BPH (AUC 0.943). Patients with lower plasma PSMA-positive EV concentration had greater prostate volume (50.2 vs. 33.4 cc, p < 0.001) and lower pathologic Gleason score (p = 0.025). During the median follow-up of 18 months, patients with lower plasma PSMA-positive EV concentration tended to have a lower risk of biochemical failure than those with higher levels of prostate-specific EVs (p = 0.085).
Highlights
The number of EVs observed by transmission electron microscope (TEM) was higher in prostate cancer cells than in BPH cells
Given the complexities of tumor heterogeneity and molecular evolution during the duration of treatment, a tissue biopsy sample may not be a true representation of the molecular profile of the individual patient
Unlike Prostate-specific antigen (PSA) screening or monitoring, which may not cancer-specific, we successfully demonstrated a difference in plasma prostate-specific EV concentration between BPH and Prostate cancer (PCa), together with differences in pathologic outcomes of PCa patients according to the plasma EV concentration
Summary
We aimed to investigate the prognostic potential of prostate-specific EVs in prostate cancer (PCa) patients. We aimed to investigate the levels of prostate-specific EVs isolated from the plasma of patients with benign prostatic hyperplasia (BPH) and PCa of different stage and grade and to evaluate the prognostic potential of prostate-specific EVs in PCa patients
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