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Abstract

Volume 14, Issue 3 (May 2012) 14, 375–384; 10.1038/aja.2011.148

Nuclear morphometry, nucleomics and prostate cancer progression

Robert W Veltri1, Christhunesa S Christudass2 and Sumit Isharwal3

1 Fisher Biomarker & Biorepository Laboratory, The Brady Urological Research Institute, Baltimore, MD 21287, USA
2 The Brady Urological Research Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA
3 Urologic Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA

Correspondence: Dr RW Veltri, (rveltri1@jhmi.edu)

Received 8 October 2011; Revised 18 November 2011; Accepted 1 December 2011; Advance online publication 16 April 2012

Abstract

Prostate cancer (PCa) results from a multistep process. This process includes initiation, which occurs through various aging events and multiple insults (such as chronic infection, inflammation and genetic instability through reactive oxygen species causing DNA double-strand breaks), followed by a multistep process of progression. These steps include several genetic and epigenetic alterations, as well as alterations to the chromatin structure, which occur in response to the carcinogenic stress-related events that sustain proliferative signaling. Events such as evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis are readily observed. In addition, in conjunction with these critical drivers of carcinogenesis, other factors related to the etiopathogenesis of PCa, involving energy metabolism and evasion of the immune surveillance system, appear to be involved. In addition, when cancer spread and metastasis occur, the 'tumor microenvironment' in the bone of PCa patients may provide a way to sustain dormancy or senescence and eventually establish a 'seed and soil' site where PCa proliferation and growth may occur over time. When PCa is initiated and progression ensues, significant alterations in nuclear size, shape and heterochromatin (DNA transcription) organization are found, and key nuclear transcriptional and structural proteins, as well as multiple nuclear bodies can lead to precancerous and malignant changes. These series of cellular and tissue-related malignancy-associated events can be quantified to assess disease progression and management.

Keywords: active surveillance; cancer metastasis; cancer progression; digital image analysis; molecular biomarkers; morphological biomarkers; nuclear morphometry; nuclear proteins and nuclear structure; prostate cancer

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