Abstract
BackgroundTMPRSS2:ERG gene aberration may be a novel marker that improves risk stratification of prostate cancer before definitive cancer therapy, but studies have been inconclusive.MethodsThe study cohort consisted of 202 operable prostate cancer Slovenian patients who underwent laparoscopic radical prostatectomy. We retrospectively constructed tissue microarrays of their prostatic specimens for fluorescence in situ hybridization, with appropriate signals obtained in 148 patients for subsequent statistical analyses.ResultsThe following genetic aberrations were found: TMPRSS2:ERG fusion, TMPRSS2 split (a non-ERG translocation) and ERG split (an ERG translocation without involvement of TMPRSS2). TMPRSS2:ERG gene fusion happened in 63 patients (42 %), TMPRSS2 split in 12 patients and ERG split in 8 patients. Association was tested between TMPRSS2:ERG gene fusion and several clinicopathological variables, i.e., pT stage, extended lymph node dissection status, and Gleason score, correcting for multiple comparisons. Only the association with pT stage was significant at p = 0.05: Of 62 patients with pT3 stage, 34 (55 %) had TMPRSS2:ERG gene fusion. In pT3 stage patients, stronger (but not significant) association between eLND status and TMPRSS2:ERG gene fusion was detected. We detected TMPRSS2:ERG gene fusion in 64 % of the pT3 stage patients where we did not perform an extended lymph node dissection.ConclusionsOur results indicate that it is possible to predict pT3 stage at final histology from TMPRSS2:ERG gene fusion at initial core needle biopsy. FISH determination of TMPRSS2:ERG gene fusion may be particularly useful for patients scheduled to undergo a radical prostatectomy in order to improve oncological and functional results.
Highlights
TMPRSS2:ERG gene aberration may be a novel marker that improves risk stratification of prostate cancer before definitive cancer therapy, but studies have been inconclusive
We found TMPRSS2:ERG gene fusion in 63 patients (42 %), TMPRSS2 split in 12 patients and ERG split in 8 patients
Based on our results, we expect that more than half of the patients with TMPRSS2:ERG gene fusion at their initial core needle biopsy will have a pT3 stage at their final histology in more than one half of the cases. This is especially important for patients with preoperative prostatic specific antigen (PSA) and Gleason score (GS) values indicating a low or intermediate risk of Prostate cancer (PCa)
Summary
TMPRSS2:ERG gene aberration may be a novel marker that improves risk stratification of prostate cancer before definitive cancer therapy, but studies have been inconclusive. Prostate cancer (PCa) is the most common cancer in males and one of the major leading causes of morbidity and mortality. With the widespread use of serum prostatic specific antigen (PSA) screening, almost 90 % of PCa cases can be diagnosed. On the other hand, screening is associated with overdiagnosis and overtreatment with an impact on the patient’s quality of life [2, 3]. The identification of the common TMPRSS2:ERG gene fusion in PCa could enable us to detect the disease in an earlier stage and make it possible to design the proper therapy for each patient. In this study we examined potential associations between TMPRSS2:ERG
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