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Periprostatic fat adipokine expression is correlated with prostate cancer aggressiveness in men undergoing radical prostatectomy for clinically localized disease
Author(s) -
Dahran Naief,
SzewczykBieda Magdalena,
Vinnicombe Sarah,
Fleming Stewart,
Nabi Ghulam
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14469
Subject(s) - prostatectomy , adipokine , medicine , prostate cancer , urology , disease , prostate , oncology , cancer , obesity , leptin
Objectives To investigate the relationship between periprostatic adipose tissue ( PPAT ) adipokine expression and prostate cancer ( PC a) aggressiveness using both pathological features of radical prostatectomy ( RP ) and multiparametric magnetic resonance imaging ( MRI ) variables. Patients and Methods Sixty‐nine men were recruited to assess immunohistochemical expression of tumour necrosis factor ( TNF )α and vascular endothelial growth factor ( VEGF ) of periprostatic fat of RP specimens. Per cent immunopositivity was quantified on scanned slides using the Aperio Positive Pixel Count algorithm for PPAT TNF α, VEGF and androgen receptors. Periprostatic fat volume ( PFV ) was segmented on contiguous T 1 ‐weighted axial MRI slices from the level of the prostate base to apex. PFV was normalized to prostate volume ( PV ) to account for variations in PV (normalized PFV = PFV / PV ). MRI quantitative values ( K ep , K trans and apparent diffusion coefficient) were measured from the PC a primary lesion using Olea Sphere software. Patients were stratified into three groups according to RP Gleason score ( GS ): ≤6, 7(3 + 4) and ≥7(4 + 3). Results The mean rank of VEGF and TNF α was significantly different between the groups [H(2) = 11.038, P = 0.004] and [H(2) = 13.086, P = 0.001], respectively. Patients with stage pT 3 had higher TNF α (18.2 ± 8.95) positivity than patients with stage pT 2 (13.27 ± 10.66; t [67] = −2.03, P = 0.047). TNF α expression significantly correlated with K trans (ρ = 0.327, P = 0.023). TNF α ( P = 0.043), and VEGF ( P = 0.02) correlated with high grade PC a ( GS ≥ 7) in RP specimens and also correlated significantly with upgrading of GS from biopsy to RP histology. Conclusions The expression levels of TNF α and VEGF on immunostaining significantly correlated with aggressivity of PC a. As biomarkers, these indicate the risk of having high grade PC a in men undergoing RP .