Abstract Gleason score (GS) is a powerful prognostic factor in prostate cancer (PCa). A GS-7 tumor typically has the primary architectural pattern and secondary prevalent one being graded as 3 and 4 or 4 and 3, respectively. Due to the well-known multifocal occurrence of different patterns, a biological sample from a GS-7 tumor used in a molecular experiment will be uncertain regarding the actually represented pattern if no special attention is given to specimen preparation. In this study, by an integrative analysis of public gene expression datasets for PCa, we demonstrate that such an uncertainty is not uncommon. First, based on a unique dataset (Sowalsky, et.al, Clin. Cancer Res., 2017) of paired Gleason pattern 3 (GP-3) and Gleason pattern 4 (GP- 4) specimens of 13 GS-7 tumors, we identify 303 differentially expressed genes with respect to those two architectural patterns. Then, using the TCGA data, we show that the profile of these genes is a strong signature for distinguishing the GS-6 (3+3) tumors from the GS-8 (4+4) ones (AUC = 0.96, p-value = 9*10E-17), implying that the differences of transcription program between the GS-8 (4+4) and GS-6 (3+3) samples resemble the differences between the GP-3 and GP-4 specimens. We further demonstrate that the co-expression pattern of the signature genes in the subset of the GS-7 samples resembles that present in the aggregate of GS-6 and GS-8 samples. Finally, we verify the findings using the GSE21032 data. Our results suggest that the GS-7 specimens used to generate two frequently-cited genome-wide expression datasets largely are individual GP-3 or GP-4 specimens rather than the “intermediate” specimens of GP-3 and GP-4. This provides molecular evidence for the aforementioned uncertainty of GS-7 tumor samples, indicating a potential pitfall in the existing molecular and translational research of prostate tumors relevant to GS. Citation Format: Wensheng Zhang, Yan Dong, Kun Zhang. Gene expression analysis reveals a pitfall in the molecular research of prostate tumors relevant to Gleason score [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 823.
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