Department of Pathology and Forensic Medicine, Postgraduate Program in Medical-Surgical Sciences of the Department of Surgery of the Federal University of Ceará, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Brazil.
Hospital Haroldo Juaçaba, Ceará Cancer Institute, Pathology Laboratory, 1222, Papi Junior St. Rodolfo Teófilo, Fortaleza, Ceará 60351-010, Brazil.
Ann Diagn Pathol. 2021 Jun;52:151729. doi: 10.1016/j.anndiagpath.2021.151729. Epub 2021 Mar 1.
Risk assessment is important when planning treatment for prostatic adenocarcinoma. Gleason score is a strong predictor of disease progression, despite the possibility of mismatches between biopsy and prostatectomy. In order to increase the accuracy of Gleason scores, several markers have been proposed. One of these, FUS (fused in sarcoma), plays a role in RNA processing, chromosome stability and gene transcription.
Non-neoplastic tissue and Gleason pattern 3, 4 and 5 adenocarcinoma samples were submitted to tissue microarrays. Gleason pattern 3 and 4 were compared to the final Gleason score. We also conducted univariate and multivariate tests to probe the association between FUS expression in adenocarcinoma samples and outcome: biochemical persistence and biochemical recurrence (separately or pooled as biochemical progression), biochemical failure after salvage radiotherapy, and systemic progression.
Our cohort consisted of 636 patients. Non-neoplastic tissue stained less frequently (36.5%) than neoplastic tissue (47.4%), with expression increasing from Gleason pattern 3 towards pattern 5. FUS-positive Gleason pattern 3 was significantly associated with final Gleason scores >6 (HR = 1.765 [1.203-2.589]; p = 0.004). Likewise, FUS-positive Gleason pattern 4 was significantly associated with final Gleason scores ≥7 (4 + 3). The association between FUS positivity and biochemical persistence and recurrence observed in the univariate analysis was not maintained in the multivariate analysis (HR = 1.147 [0.878-1.499]; p = 0.313).
Non-neoplastic tissue was less frequently FUS-positive than neoplastic tissue. FUS positivity in Gleason pattern 3 and 4 increased the risk of high grade adenocarcinoma and was associated with clinical/laboratory progression in the univariate, but not in multivariate analysis.
在计划前列腺腺癌的治疗时，风险评估很重要。尽管活检和前列腺切除术之间可能存在不匹配，但格里森评分是疾病进展的强有力预测指标。为了提高格里森评分的准确性，已经提出了几种标记物。其中一种是融合肉瘤（FUS），它在 RNA 处理、染色体稳定性和基因转录中发挥作用。
非肿瘤组织和格里森 3、4 和 5 型腺癌样本被提交用于组织微阵列。将格里森 3 型和 4 型与最终格里森评分进行比较。我们还进行了单变量和多变量检验，以探讨腺癌样本中 FUS 表达与结局的关系：生化持续存在和生化复发（分别或合并为生化进展）、挽救性放疗后的生化失败以及全身进展。
我们的队列包括 636 名患者。非肿瘤组织的染色频率（36.5%）低于肿瘤组织（47.4%），表达从格里森 3 型向 5 型增加。FUS 阳性的格里森 3 型与最终格里森评分>6 显著相关（HR=1.765[1.203-2.589]；p=0.004）。同样，FUS 阳性的格里森 4 型与最终格里森评分≥7（4+3）显著相关。单变量分析中观察到的 FUS 阳性与生化持续存在和复发之间的关联在多变量分析中并未维持（HR=1.147[0.878-1.499]；p=0.313）。
非肿瘤组织的 FUS 阳性率低于肿瘤组织。格里森 3 型和 4 型的 FUS 阳性增加了高级别腺癌的风险，并与单变量分析中的临床/实验室进展相关，但与多变量分析无关。
