title: High density of S100A9 positive inflammatory cells in prostate cancer stroma is associated with poor outcome.
abstract: OBJECTIVE
  To elucidate if the density of inflammatory cells expressing S100A9 in malignant and surrounding non-malignant prostate tissues is a prognostic marker for outcome in prostate cancer patients.
  
  
  METHODS
  Tissue was obtained from 358 men diagnosed with prostate cancer at transurethral resection of the prostate due to obstructive voiding problems, of which 260 were then followed with watchful waiting. Tissue microarrays of both malignant and non-malignant tissues were stained with an antibody against S100A9. The number of stained inflammatory cells was scored and related to clinical outcome and histopathological parameters of known prognostic value.
  
  
  RESULTS
  A high number of inflammatory cells expressing S100A9 in both malignant and surrounding non-malignant tissues were associated with significantly shorter cancer-specific survival. This association remained significant when Gleason score and local tumour stage were analysed together with S100A9 in a Cox regression model. Low number of S100A9 positive cells in non-malignant stroma was correlated to significantly longer cancer-specific survival also in patients with Gleason score 8-10 tumours. S100A9 positive cells in tumour stroma were correlated with Gleason score, hyaluronan, platelet-derived growth factor receptor beta (PDGFR-β), and androgen receptor (inverse correlation) in tumour stroma. S100A9 positive cells in non-malignant stroma correlated with androgen receptor in this tissue compartment (inverse correlation).
  
  
  CONCLUSIONS
  A high number of S100A9 positive inflammatory cells in tumour stroma and in non-malignant stroma were associated with shorter cancer-specific survival in prostate cancer patients.
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Tidehag
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Hammarsten
authors.affiliation: Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.affiliation: Department of Urology, Central Hospital, Västerås, Sweden.
authors.forename: Torvald
authors.initials: T
authors.lastname: Granfors
authors.affiliation: Department of Surgical and Perioperative Sciences, Urology & Andrology, Umeå University, Umeå, Sweden.
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.affiliation: Department of Immunology, Lund University, Lund, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Leanderson
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Wikström
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Josefsson
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Hägglöf
authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. Electronic address: anders.bergh@medbio.umu.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Bergh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D040502:Calgranulin B / Q000032:analysis*; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000378:metabolism* / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D017154:Stromal Cells / Q000737:chemistry* / Q000473:pathology; D013997:Time Factors; D046888:Tissue Array Analysis; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D015854:Up-Regulation; D057832:Watchful Waiting
chemical_list: D014408:Biomarkers, Tumor; D040502:Calgranulin B
keywords: Prognostic marker; Prostate cancer; S100A9; Watchful waiting