Expressie van eiwit Hsp-27 in urine bij diagnose voorspelt mate van agressiviteit van prostaatkanker en kan wel of niet behandelen bepalen.

25 augustus 2009: Bron: BBC news

De activiteit en aanwezigheid van een bepaald eiwit (Hsp-27) in de urine van mannen met signalen van prostaatkanker zou kunnen voorspellen of de prostaatkanker zich agressief zal ontwikkelen en snelle behandeling vereist of dat een wait and see beleid wellicht beter is. Dat concluderen Britse onderzoekers van de universiteit van Liverpool uit de resultaten van een studie bij ruim 500 mannen. Mannen waarbij het Hsp-27 eiwit bij diagnose veel aanwezig was hadden een twee keer zo grote kans op overlijden aan hun prostaatkanker. Dit onderzoek zou een urinetest voor prostaatkanker dichterbij brengen. De studie wordt deze week gepubliceerd in The British Journal of Cancer. Hier het abstract:

British Journal of Cancer advance online publication 25 August 2009; doi: 10.1038/sj.bjc.6605227

Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement

C S Foster¹, A R Dodson¹, L Ambroisine², G Fisher², H Møller³, J Clark⁴, G Attard⁴, J De-Bono⁴, P Scardino⁵, V E Reuter⁵, C S Cooper⁴, D M Berney⁶ and J Cuzick² on behalf of the Trans-Atlantic Prostate Group

¹Division of Cellular Pathology and Molecular Genetics, University of Liverpool, Duncan Building, Daulby Street, Liverpool L69 3GA, UK
²Cancer Research UK Centre for Epidemiology, Mathematics and Statistics Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
³King's College London, Thames Cancer Registry, 42 Weston Street, London SE1 3QD, UK
⁴Institute of Cancer Research, Male Urological Cancer Research Centre, 15 Cotswold Road, Belmont, Sutton, Surrey SM2 5NG, UK
⁵Departments of Urology and Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
⁶The Orchid Tissue Laboratory, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, London E1 2AD, UK

Correspondence: Professor CS Foster, Division of Cellular Pathology and Molecular Genetics, School of Cancer Studies, University of Liverpool, 6th Floor, Duncan Building, Daulby Street, Liverpool L69 3GA, UK. E-mail: csfoster@liv.ac.uk

Received 3 April 2009; Revised 2 July 2009; Accepted 9 July 2009; Published online 25 August 2009.

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Abstract

Background:

This study was performed to test the hypothesis that expression of small heat shock protein Hsp-27 is, at diagnosis, a reliable predictive biomarker of clinically aggressive prostate cancer.

Methods:

A panel of tissue microarrays constructed from a well-characterised cohort of 553 men with conservatively managed prostate cancer was stained immunohistochemically to detect Hsp-27 protein. Hsp-27 expression was compared with a series of pathological and clinical parameters, including outcome.

Results:

Hsp-27 staining was indicative of higher Gleason score (P<0.001). In tissue cores having a Gleason score >7, the presence of Hsp-27 retained its power to independently predict poor clinical outcome (P<0.002). Higher levels of Hsp-27 staining were almost entirely restricted to cancers lacking ERG rearrangements (² trend=31.4, P<0.001), although this distribution did not have prognostic significance.

Interpretation:

This study has confirmed that, in prostate cancers managed conservatively over a period of more than 15 years, expression of Hsp-27 is an accurate and independent predictive biomarker of aggressive disease with poor clinical outcome (P<0.001). These findings suggest that apoptotic and cell-migration pathways modulated by Hsp-27 may contain targets susceptible to the development of biologically appropriate chemotherapeutic agents that are likely to prove effective in treating aggressive prostate cancers.

diagnose, prostaatkanker, eiwit Hsp-27