title: Expression levels of heat shock protein 27 and cellular FLICE-like inhibitory protein in prostate cancer correlate with Gleason score sum and pathologic stage.
abstract: OBJECTIVE
  Heat shock protein (HSP) 27 protects the cell by controlling apoptosis and immune reactions, and c-FLIP (cellular-FLICE inhibitory protein) inhibits apoptosis by inhibiting caspase-8 activity. We investigated the relationship of HSP27 and c-FLIP expression to prostate-specific antigen, Gleason score sum (GSS), and pathologic stage.
  
  
  METHODS
  Samples from 163 patients between May 2004 and April 2010 were analyzed: 83 from patients that had underwent a radical prostatectomy, and 80 from those that underwent transurethral resection of the prostate to alleviate urinary symptoms from benign prostate hyperplasia. c-FLIP and HSP27 expression were observed by immunohistochemistry staining. Samples with less than 5% expression-positive cells were scored as 1, with 5%-50% were scored as 2, and with more than 50% were scored as 3. Local reactions were identified as 0.5 and evaluated.
  
  
  RESULTS
  Both the presence of HSP27 within the tumor and the number of cancer cells positive for HSP27 were significantly correlated to GSS and pathologic stage (p<0.001, p=0.001, p<0.001, p<0.001). The same was true for c-FLIP expression (p<0.001). GSS was more highly correlated to HSP27 expression than to c-FLIP expression (r=0.814 for HSP27, r=0.776 for c-FLIP), as was pathologic stage (r=0.592 for HSP27, r=0.554 for c-FLIP).
  
  
  CONCLUSIONS
  In prostate cancer, higher GSS and a more advanced pathologic stage were associated with a higher likelihood of having a HSP27-positive tumor and more HSP27-positive tumor cells. HSP27 expression was correlated with GSS and prostate cancer stage. A more advanced pathologic stage corresponded to a higher likelihood of having a c-FLIP-positive tumor and more c-FLIP-positive tumor cells. HSP27 expression had a higher correlation with prostate cancer stage and GSS than c-FLIP expression did.
authors.affiliation: Department of Urology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea.
authors.forename: Seung Wook
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Jeoung Man
authors.initials: JM
authors.lastname: Cho
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Hee Ju
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Jung Yoon
authors.initials: JY
authors.lastname: Kang
authors.affiliation: Department of Pathology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Tag Keun
authors.initials: TK
authors.lastname: Yoo
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D053446:CASP8 and FADD-Like Apoptosis Regulating Protein / Q000378:metabolism*; D055551:HSP27 Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000378:metabolism / Q000601:surgery; D011471:Prostatic Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D020728:Transurethral Resection of Prostate
chemical_list: D014408:Biomarkers, Tumor; D053446:CASP8 and FADD-Like Apoptosis Regulating Protein; C506386:CFLAR protein, human; D055551:HSP27 Heat-Shock Proteins; D009363:Neoplasm Proteins
keywords: Clinical pathology; Heat-shock proteins; Neoplasm grading; Prostatic neoplasms