Yesterday we reported a study suggesting the potential of hyalouronidase staining as a method to differentiate between aggressive and indolent prostate cancers at the time of diagnosis. Now a report in the British Journal of Cancer suggests that heat shock protein 27 (Hsp-27) may also have this potential.
Clearly the heat is starting to get “turned up” on tests that may allow us to better assess prostate cancer risk at an early stage. And about time too!
According to a BBC news report, the new study, conducted by an international research team, suggests that “Men who tested positive for Hsp-27 at diagnosis were almost twice as likely to die from [prostate cancer] in the next 15 years than those who did not.”
The article by Foster et al. is based on a laboratory study in which pathological tissue from a well-characterized cohort of 553 men with conservatively managed prostate cancer was stained immunohistochemically to detect Hsp-27 protein. The presence of Hsp-27 expression was then compared with a series of pathological and clinical parameters, including the patients’ outcomes.
The results of the study showed that:
- Hsp-27 staining was indicative of higher Gleason score (P < 0.001).
- In tissue cores having a Gleason score > 7, the presence of Hsp-27 retained its power to independently predict poor clinical outcome (P<0.002).
- Higher levels of Hsp-27 staining were almost entirely limited to prostate cancers which did not have rearrangements of the ERG, but this distribution did not have prognostic significance.
In the opinion of the authors, “This study has confirmed that, in prostate cancers managed conservatively over a period of more than 15 years, expression of Hsp-27 is an accurate and independent predictive biomarker of aggressive disease with poor clinical outcome.” They further state that biochemical pathways modulated by Hsp-27 “may contain targets susceptible to the development of biologically appropriate chemotherapeutic agents that are likely to prove effective in treating aggressive prostate cancers.”
These data alone are insufficient to make the decision to start testing every patient’s positive biopsy cores for the presence of Hsp-27, but they are certainly sufficient to continue clinical research on the potential of Hsp-27 as a diagnostic and prognostic marker for aggressive prostate cancer. Of course it would be better if we could find a test that could give us this type of information before a biopsy became necessary at all!
Filed under: Diagnosis, Risk Tagged: | aggressive, heat shock protein, Hsp-27, risk
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