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Volume 24, Issue 1 (January 2022) 24, 50–55; 10.4103/aja.aja_39_21

Prognostic value of PTEN in de novo diagnosed metastatic prostate cancer

Jun-Yu Zhang1, Yun-Yi Kong2, Qi-Feng Wang2, Yun-Jie Yang1, Zheng Liu1, Nan Lin1, Ding-Wei Ye1, Bo Dai1

1 Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
2 Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China

Correspondence: Dr. B Dai (bodai1978@126.com) or Dr. DW Ye (dwyeli@163.com)

Date of Submission 10-Aug-2020 Date of Acceptance 24-Mar-2021 Date of Web Publication 28-May-2021


The purpose of our study is to investigate the prognostic value of phosphatase and tensin homolog on chromosome 10 (PTEN) expression in patients with de novo metastatic castration naïve prostate cancer (mCNPC). A total of 205 patients with mCNPC at Fudan University Shanghai Cancer Center (Shanghai, China) were retrospectively examined. Immunohistochemical staining of PTEN was performed on prostate biopsy samples of these patients. Associations among clinicopathological features, patient survival and PTEN protein expression were analyzed. PTEN loss occurred in 58 of 205 (28.3%) patients. Loss of PTEN was significantly correlated with high metastatic volume (P = 0.017). No association between PTEN expression and Gleason score was observed. Patients with PTEN loss had significantly shorter progression-free survival (PFS, P < 0.001) and overall survival (OS, P < 0.001) compared with patients with intact PTEN expression. Multivariate analysis showed that elevated alkaline phosphatase, high metastatic volume and PTEN loss were independent poor prognostic factors for PFS. The Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 and PTEN loss were independent poor prognostic factors for OS. The adjusted hazard ratio of PTEN loss for PFS and OS was 1.67 (95% confidence interval [CI]: 1.14–2.43, P = 0.008) and 1.95 (95% CI: 1.23–3.10, P = 0.005), respectively. PTEN loss was also significantly associated with shorter PFS (P = 0.025) and OS (P < 0.001) in patients with low-volume metastatic disease. Our data showed that PTEN loss is an independent predictor for shorter PFS and OS in patients with de novo mCNPC.

Keywords: immunohistochemistry; metastatic prostate cancer; metastatic volume; phosphatase and tensin homolog on chromosome 10; prognosis

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