title: Overexpression of ERG and Wild-Type PTEN Are Associated with Favorable Clinical Prognosis and Low Biochemical Recurrence in Prostate Cancer.
abstract: OBJECTIVE
  The aim of this study was to investigate the expression of two commonly altered genes ERG and PTEN in prostate cancer (PC) and evaluate their prognostic significance. Despite conflicting published results, TMPRSS2-ERG gene fusion and PTEN loss are generally considered unfavorable markers for PC progression.
  
  
  METHODS
  Of the 762 prostatic adenocarcinoma specimens obtained from radical prostatectomy, 613 without neoadjuvant hormone therapy were included in tissue microarrays for quantitatively assessment of ERG and PTEN expression via immunohistochemistry. Statistical analysis of the association between such expression and clinicopathological parameters, including clinical prognosis, was performed with a p-value of <0.05 considered significant.
  
  
  RESULTS
  During a median follow-up period of 44.0 months, 132 (21.5%) patients developed biochemical recurrence (BCR). ERG overexpression and PTEN loss were observed in 145 (23.7%) and 253 (41.3%) cases, respectively. BCR-free survival was significantly better in patients with ERG overexpression (p=0.005), but unfavorable among those with PTEN loss (p=0.142). Sub-group analysis revealed that patients with PTEN loss and negative ERG expression had the worst BCR-free survival outcome (p=0.021). Furthermore, multivariate analysis identified prostate-specific antigen level (≥10 ng/mL), Gleason score (>6), pathologic T stage (≥T3), positive surgical margin, and extraprostatic capsule extension as significant risk factors for BCR (p<0.05).
  
  
  CONCLUSIONS
  Our results indicated that ERG overexpression was associated with favorable BCR-free survival after radical prostatectomy for PC, whereas PTEN loss was with unfavorable outcomes.
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Sung Han
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pathology, Yonsei University Severance Hospital, Seoul.
authors.forename: Soo Hee
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.affiliation: Department of Pathology, Center for Prostate cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Geon Kook
authors.initials: GK
authors.lastname: Lee
authors.affiliation: Department of Pathology, Center for Prostate cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Hong
authors.affiliation: Biometric Research Branch, National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Kyung Min
authors.initials: KM
authors.lastname: Kang
authors.affiliation: Biometric Research Branch, National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Ami
authors.initials: A
authors.lastname: Yu
authors.affiliation: Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea; Department of Pathology, Center for Prostate cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.affiliation: Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Gyeonggi-do, Korea.
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D018572:Disease-Free Survival; D015870:Gene Expression; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000401:mortality / Q000517:prevention & control; D051059:PTEN Phosphohydrolase / Q000235:genetics / Q000378:metabolism*; D011379:Prognosis; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D015534:Trans-Activators / Q000235:genetics / Q000378:metabolism*; D000071230:Transcriptional Regulator ERG
chemical_list: D014408:Biomarkers, Tumor; C072312:ERG protein, human; D015534:Trans-Activators; D000071230:Transcriptional Regulator ERG; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human