The identification of new prognostic markers for prostate cancer is highly warranted, since it is difficult to identify patients requiring curative treatment. Data from both experimental models and clinical samples have identified important functions of PDGFRβ on pericytes and fibroblasts in the tumor stroma. In this study the prognostic significance of PDGFRβ in prostate cancer stroma, and in matched non-malignant tissue, was evaluated with immunohistochemistry. PDGFRβ expression was analyzed in normal and tumor stroma from more than 300 prostate cancer patients. High PDGFRβ expression in tumor stroma was associated with large tumor size, advanced stage, high Gleason score and high vessel density. Perivascular PDGFRβ staining in tumors was also correlated with high Gleason score. Correlations were also observed between PDGFRβ status in tumor stroma and non-malignant stroma. Similarly, high PDGFRβ expression in adjacent non-malignant tissue stroma correlated with large tumor size, advanced stage, high Gleason score and proliferation in non-malignant epithelium. Interestingly, high levels of PDGFRβ in the stroma of tumor and non-malignant tissue were associated with shorter cancer specific survival in prostate cancer patients. The study revealed a number of novel associations between stromal PDGFRβ expression in prostate tumors and several important clinical characteristics, including survival.
The TMPRSS2-ERG gene fusion is found in approximately half of all prostate cancers. The functional and prognostic significance of TMPRSS2-ERG is, however, not fully understood. Based on a historical watchful waiting cohort, an association between TMPRSS2-ERG, evaluated as positive immune staining, and shorter survival of prostate cancer patients was identified. Expression of ERG was also associated with clinical markers such as advanced tumor stage, high Gleason score, presence of metastasis and prognostic tumor cell markers such as high Ki67, pEGFR and pAkt. Novel associations between TMPRSS2-ERG and alterations in the tumor stroma, for example, increased vascular density, hyaluronan and PDGFRβ and decreased Caveolin-1, all known to be associated with an aggressive disease, were found. The present study suggests that the TMPRSS2-ERG fusion gene is associated with a more aggressive prostate cancer phenotype, supported by changes in the tumor stroma.
Purpose: To explore if the expression of phosphorylated epidermal growth factor receptor (pEGFR) in nonmalignant and malignant prostate tissue is a potential prognostic marker for outcome in prostate cancer patients.