Premium
PTEN loss in prostatic adenocarcinoma correlates with specific adverse histologic features (intraductal carcinoma, cribriform Gleason pattern 4 and stromogenic carcinoma)
Author(s) -
Shah Rajal B.,
Shore Karen T.,
Yoon Jiyoon,
Mendrinos Savvas,
McKenney Jesse K.,
Tian Wei
Publication year - 2019
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23831
Subject(s) - pten , prostate cancer , pathology , carcinoma , prostate , immunohistochemistry , medicine , cancer , adenocarcinoma , stromal cell , cancer research , biology , apoptosis , pi3k/akt/mtor pathway , biochemistry
Background The loss of PTEN tumor suppressor gene is one of the most common somatic genetic aberrations in prostate cancer (PCa) and is frequently associated with high‐risk disease. Deletion or mutation of at least one PTEN allele has been reported to occur in 20% to 40% of localized PCa and up to 60% of metastases. The goal of this study was to determine if somatic alteration detected by PTEN immunohistochemical loss of expression is associated with specific histologic features. Methods Two hundred sixty prostate core needle biopsies with PCa were assessed for PTEN loss using an analytically validated immunohistochemical assay. Blinded to PTEN status, each tumor was assessed for the Grade Group (GG) and the presence or absence of nine epithelial features. Presence of stromogenic PCa was also assessed and defined as grade 3 reactive tumor stroma as previously described: the presence of carcinoma associated stromal response with epithelial to stroma ratio of greater than 50% reactive stroma. Results Eight‐eight (34%) cases exhibited PTEN loss while 172 (66%) had intact PTEN. PTEN loss was significantly ( P < 0.05) associated with increasing GG, poorly formed glands (74% of total cases with loss vs 49% of intact), and three well‐validated unfavorable pathological features: intraductal carcinoma of the prostate (IDC‐P) (69% of total cases with loss vs 12% of intact), cribriform Gleason pattern 4 (38% of total cases with loss vs 10% of intact) and stromogenic PCa (23% of total cases with loss vs 6% of intact). IDC‐P had the highest relative risk (4.993, 95% confidence interval, 3.451‐7.223, P < 0.001) for PTEN loss. At least one of these three unfavorable pathological features were present in 67% of PCa exhibiting PTEN loss, while only 11% of PCa exhibited PTEN loss when none of these three unfavorable pathological features were present. Conclusions PCa with PTEN loss demonstrates a strong correlation with known unfavorable histologic features, particularly IDC‐P. This is the first study showing the association of PTEN loss with stromogenic PCa.