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zeste同源物2增强子(EZH2)的过表达是侵袭性前列腺癌亚群的特征,并且独立于术前和术后评估的临床病理参数预测患者预后。

Overexpression of enhancer of zeste homolog 2 (EZH2) characterizes an aggressive subset of prostate cancers and predicts patient prognosis independently from pre- and postoperatively assessed clinicopathological parameters.

作者信息

Melling Nathaniel, Thomsen Erik, Tsourlakis Maria Christina, Kluth Martina, Hube-Magg Claudia, Minner Sarah, Koop Christina, Graefen Markus, Heinzer Hans, Wittmer Corinna, Sauter Guido, Wilczak Waldemar, Huland Hartwig, Simon Ronald, Schlomm Thorsten, Steurer Stefan, Krech Till

机构信息

Institute of Pathology, General, Visceral and Thoracic Surgery Department and Clinic.

Institute of Pathology.

出版信息

Carcinogenesis. 2015 Nov;36(11):1333-40. doi: 10.1093/carcin/bgv137. Epub 2015 Sep 21.

Abstract

Enhancer of zeste homolog 2 (EZH2) plays an important role in tumor development and progression by interacting with histone and nonhistone proteins. In the current study, we analyzed prevalence and prognostic impact of EZH2 in prostate cancer. EZH2 expression was analyzed by immunohistochemistry on a tissue microarray containing more than 12400 prostate cancer specimens. Results were compared to tumor phenotype, biochemical recurrence and molecular subtypes defined by ERG status as well as genomic deletions of 3p, 5q, 6q and PTEN. EZH2 immunostaining was detectable in 56.6% of 10168 interpretable cancers and considered strong in 1.1%, moderate in 12.2% and weak in 43.3% of cases. High EZH2 expression was strongly associated with high Gleason grade (P < 0.0001), advanced pathological tumor stage (P < 0.0001), positive nodal status (P < 0.0001), elevated preoperative PSA level (P = 0.0066), early PSA recurrence (P < 0.0001) and increased cell proliferation P < 0.0001). High-level EZH2 staining was also associated with TMPRSS2:ERG rearrangement and ERG expression in prostate cancers (P < 0.0001) and was linked to deletions of PTEN, 6q15, 5q21 and 3p13 (P < 0.0001 each) particularly in ERG-negative cancers. The prognostic impact of EZH2 was independent of established pre- and postoperatively assessed clinicopathological parameters. EZH2 has strong prognostic impact in prostate cancer and might contribute to the development of a fraction of genetically instable and particularly aggressive prostate cancers. EZH2 analysis might therefore be of clinical value for risk stratification of prostate cancer.

摘要

zeste同源物2增强子(EZH2)通过与组蛋白和非组蛋白相互作用,在肿瘤发生和发展中发挥重要作用。在本研究中,我们分析了EZH2在前列腺癌中的发生率及其预后影响。通过免疫组织化学方法,在包含超过12400例前列腺癌标本的组织芯片上分析EZH2表达情况。将结果与肿瘤表型、生化复发、由ERG状态定义的分子亚型以及3p、5q、6q和PTEN的基因组缺失情况进行比较。在10168例可解释的癌症中,56.6%可检测到EZH2免疫染色,其中1.1%为强阳性,12.2%为中度阳性,43.3%为弱阳性。EZH2高表达与高Gleason分级(P < 0.0001)、晚期病理肿瘤分期(P < 0.0001)、阳性淋巴结状态(P < 0.0001)、术前PSA水平升高(P = 0.0066)、早期PSA复发(P < 0.0001)以及细胞增殖增加(P < 0.0001)密切相关。高水平的EZH2染色也与前列腺癌中的TMPRSS2:ERG重排和ERG表达相关(P < 0.0001),并且与PTEN、6q15、5q21和3p13的缺失相关(各P < 0.0001),尤其在ERG阴性癌症中。EZH2的预后影响独立于术前和术后评估的既定临床病理参数。EZH2在前列腺癌中具有很强的预后影响,可能有助于部分基因不稳定且侵袭性特别强的前列腺癌的发生发展。因此,EZH2分析可能对前列腺癌的风险分层具有临床价值。

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