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Cancer stem cell markers in prostate cancer: an immunohistochemical study of ALDH1, SOX2 and EZH2

Matsika, Admire1,2,3; Srinivasan, Bhuvana1; Day, Christopher1,2,3; Mader, Sabrina Ann4; Kiernan, Deirdre Margaret4; Broomfield, Amy1; Fu, Jinlin5; Hooper, John D.5; Kench, James G.6; Samaratunga, Hemamali3,7

Pathology - Journal of the RCPA: December 2015 - Volume 47 - Issue 7 - p 622–628
doi: 10.1097/PAT.0000000000000325

Summary: The aims of this study were to investigate the immunohistochemical expression and potential prognostic significance of putative cancer stems cell markers ALDH1, EZH2 and SOX2 in prostate cancer.

A total of 142 consecutive radical prostatectomies submitted to one laboratory with a diagnosis of prostatic adenocarcinoma between 2008 and 2012 were retrieved and retrospectively studied. Immunohistochemistry for the three markers was performed in each case and both univariate and multivariate analyses were undertaken to evaluate the correlation between the staining patterns and known histopathological prognostic features.

ALDH1 showed a statistically significant association with tumour stage p < 0.001), extraprostatic extension (p < 0.001) and lymphovascular invasion (p = 0.001). EZH2 correlated with Gleason score (p = 0.044) and lymph node metastases (p = 0.023). SOX2 showed a statistically significant correlation with lymphovascular invasion only (p = 0.018) in both univariate and multivariate analyses.

Cancer stem cell markers are variably expressed in prostate adenocarcinoma and immunohistochemical staining for ALDH1 and EZH2 may have a role in predicting tumour aggressiveness before treatment of prostate cancer.

1Department of Anatomical Pathology, Mater Health Services, South Brisbane

2Pathology Queensland, Royal Brisbane and Women's Hospital, Herston

3Department of Pathology, University of Queensland, Brisbane

4Department of Urology, Mater Adult Hospital, South Brisbane

5Mater Research Institute – University of Queensland, Translational Research Institute, Woolloongabba, Qld

6Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown and Sydney Medical School, The University of Sydney, NSW

7Aquesta Pathology, Taringa, Qld, Australia

Address for correspondence: Dr A. Matsika, Mater Pathology, Mater Health Services, Level 3, Duncombe Building, Raymond Terrace, South Brisbane, Qld 4101, Australia. E-mail:

Received 11 November, 2014

Revised 28 June, 2015

Accepted 30 June, 2015

© 2015 Royal College of Pathologists of Australasia
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