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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.06.02    [Epub ahead of print]
Diverse Immunoprofile of Ductal Adenocarcinoma of the Prostate with an Emphasis on the Prognostic Factors
Se Un Jeong1, Anuja Kashikar Kekatpure1, Ja-Min Park2, Minkyu Han3, Hee Sang Hwang1, Hui Jeong Jeong1, Heounjeong Go1, Yong Mee Cho1
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Yong Mee Cho ,Tel: +82-2-3010-5965, Fax: +82-2-3010-7898, Email: yongcho@amc.seoul.kr
Received: February 28, 2017;  Revised: May 13, 2017  Accepted: June 2, 2017.  Published online: August 9, 2017.
ABSTRACT
Background:
Ductal adenocarcinoma (DAC) of the prostate is an uncommon histologic subtype whose prognostic factors and immunoprofile have not been fully defined.
Methods:
To define its prognostic factors and immunoprofile, the clinicopathological features, including biochemical recurrence (BCR), of 61 cases of DAC were analyzed. Immunohistochemistry was performed on tissue microarray constructs to assess the expression of prostate cancer-related and mammalian target of rapamycin (mTOR) signaling-related proteins.
Results:
During the median follow-up period of 19.3 months, BCR occurred in 26 cases (42.6%). DAC demonstrated a wide expression range of prostate cancer-related proteins, including nine cases (14.8%) that were totally negative for pan-cytokeratin (PanCK) immunostaining. The mTOR signaling-related proteins also showed diverse expression. On univariate analysis, BCR was associated with high preoperative serum levels of prostate-specific antigen (PSA), large tumor volume, predominant ductal component, high Gleason score (GS), comedo-necrosis, high tumor stage (pT), lymphovascular invasion, and positive surgical margin. High expressions of phospho-S6 ribosomal protein and phospho-mTOR (p-mTOR) as well as low expressions of PSA and PanCK were associated with BCR. On multivariable analysis, GS, pT, and immunohistochemical expressions of PanCK and p-mTOR remained independent prognostic factors for BCR.
Conclusions:
These results suggest GS, pT, and immunohistochemical expressions of PanCK and p-mTOR as independent prognostic factors for BCR in DAC. Since DAC showed diverse expression of prostate cancer-related proteins, this should be recognized in interpreting the immunoprofile of DAC. The diverse expression of mTOR-related proteins implicates their potential utility as predictive markers for mTOR targeted therapy.
Key Words: Prostatic neoplasms; Carcinoma, ductal; Immunohistochemistry; Prognosis