Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Rockville, MD 20852, USA.
Urology. 2012 Oct;80(4):749-53. doi: 10.1016/j.urology.2012.07.001. Epub 2012 Aug 28.
To systematically evaluate the ETS-related gene (ERG) alterations in the multifocal tumor context using whole-mount prostatectomy specimens from African and Caucasian American patients matched for age, pathologic grade and stage. Oncogenic activation of the ERG is the most common early genomic alteration in patients with prostate cancer (CaP) in Western countries. However, ERG alterations have not been systematically examined in African American patients with a known greater risk of CaP incidence and mortality.
ERG oncoprotein expression was analyzed in 91 Caucasian and 91 African American patients with CaP, who were matched for age, Gleason score, and pathologic stage. A unique aspect of the present study was the evaluation of ERG in whole-mount prostatectomy sections, minimizing sampling bias and allowing the careful assessment of the ERG in the multifocal tumor context of CaP.
The frequency of ERG-positive prostate tumors was significantly greater among Caucasian Americans than among African Americans when assessed in all tumor foci (41.9% vs 23.9%, P < .0001). A markedly greater frequency of ERG oncoprotein expression was noted between the index tumors of the Caucasian Americans (63.3%) and those of the African Americans (28.6%). Also, in the African American patients, the higher grade index tumors were predominantly ERG negative.
ERG typing of CaP established a major difference between the index tumors of Caucasian and African American patients. ERG-negative index tumors might indicate a less favorable outcome for African American patients. The results of the present study underscore that typing of CaP for the ERG could enhance our understanding of the biologic differences between the examined ethnic groups.
通过对年龄、病理分级和分期相匹配的非洲裔美国人和高加索裔美国人全前列腺切除术标本进行研究，系统评估多灶性肿瘤中 ETS 相关基因（ERG）的改变。在西方国家，ERG 的致癌激活是前列腺癌（CaP）患者中最常见的早期基因组改变。然而，在具有更高 CaP 发病率和死亡率风险的非洲裔美国患者中，尚未对 ERG 改变进行系统检查。
分析了 91 例高加索裔和 91 例非洲裔美国 CaP 患者的 ERG 癌蛋白表达情况，这些患者在年龄、Gleason 评分和病理分期方面相匹配。本研究的一个独特方面是在全前列腺切除术切片中评估 ERG，最大限度地减少采样偏差，并仔细评估 CaP 多灶性肿瘤中的 ERG。
在所有肿瘤灶中，高加索裔美国人中 ERG 阳性前列腺肿瘤的频率明显高于非洲裔美国人（41.9%比 23.9%，P<.0001）。高加索裔美国人（63.3%）和非洲裔美国人（28.6%）的原发肿瘤之间 ERG 癌蛋白表达的频率明显更高。此外，在非洲裔美国患者中，较高分级的原发肿瘤主要为 ERG 阴性。
CaP 的 ERG 分型在高加索裔和非洲裔美国患者的原发肿瘤之间存在显著差异。ERG 阴性的原发肿瘤可能预示着非洲裔美国患者的预后较差。本研究的结果强调，对 ERG 进行 CaP 分型可以增强我们对所检查的不同种族之间生物学差异的理解。
