Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Hum Pathol. 2019 Aug;90:20-26. doi: 10.1016/j.humpath.2019.04.016. Epub 2019 May 7.
Multiparametric magnetic resonance imaging (MRI)/ultrasound fusion targeted prostate biopsy has been shown to outperform systematic biopsy in the detection of clinically significant prostate cancer. Aside from tumor grade, tumor biomarkers such as phosphatase and tensin homolog (PTEN) and ETS-related gene (ERG) have prognostic significance in prostate cancer and may help direct management of patients with low-grade tumors. Our objective was to compare the detection of PTEN and ERG expression in MRI-targeted versus systematic prostate biopsies. We compared immunohistochemical expression for PTEN and ERG on prostate biopsy cores from patients with Grade Group (GG) 1 or GG2 prostate cancer who had undergone systematic biopsy with concurrent targeted biopsy. Fifty-three cases had both systematic and MRI-targeted prostate tissue available for staining for PTEN; and 52 cases, for ERG. ERG positivity was seen in 37/52 (71.2%) cases, and PTEN loss was seen in 15/53 (28.3%) cases. The detection of ERG expression was not significantly different between MRI-targeted and systematic biopsy (P = .4). Targeted biopsy was superior to systematic biopsy in the detection of PTEN loss (P = .02). MRI-targeted cores detected 14/15 (93.3%) cases of PTEN loss compared to 7/15 (46.7%) cases detected by systematic cores. Most cases with PTEN loss showed heterogeneous expression in both systematic and targeted cores. In 14/15 (93.3%) cases with PTEN loss, GG was the same between targeted and systematic biopsy. Targeted biopsy is superior to systematic biopsy in the detection of PTEN loss in GG1 and GG2 tumors. Inclusion of targeted cores may be helpful for evaluation of certain prognostic biomarkers.
多参数磁共振成像（MRI）/超声融合靶向前列腺活检已被证明在检测临床显著前列腺癌方面优于系统活检。除肿瘤分级外，肿瘤标志物如磷酸酶和张力蛋白同源物（PTEN）和 ETS 相关基因（ERG）在前列腺癌中有预后意义，并可能有助于指导低级别肿瘤患者的管理。我们的目的是比较 MRI 靶向与系统前列腺活检中 PTEN 和 ERG 表达的检测。我们比较了接受系统活检和同时靶向活检的 GG1 或 GG2 前列腺癌患者的前列腺活检核心的免疫组织化学表达 PTEN 和 ERG。53 例有系统和 MRI 靶向前列腺组织可用于 PTEN 染色；52 例可用于 ERG。在 52 例中，有 37 例（71.2%）为 ERG 阳性，15 例（28.3%）为 PTEN 缺失。MRI 靶向活检与系统活检在 ERG 表达的检测上无显著差异（P = .4）。靶向活检在检测 PTEN 缺失方面优于系统活检（P = .02）。与系统核心检测到的 7/15（46.7%）相比，MRI 靶向核心检测到 14/15（93.3%）例 PTEN 缺失。大多数 PTEN 缺失病例在系统和靶向核心中均表现出异质性表达。在 14/15（93.3%）例 PTEN 缺失中，靶向和系统活检的 GG 相同。靶向活检在 GG1 和 GG2 肿瘤中 PTEN 缺失的检测优于系统活检。包括靶向核心可能有助于评估某些预后生物标志物。
