V-ets erythroblastosis virus E26 oncogene homolog (avian)/Trefoil factor 3/high-molecular-weight cytokeratin triple immunostain: a novel tissue-based biomarker in prostate cancer with potential clinical application

Hum Pathol. 2013 Oct;44(10):2282-92. doi: 10.1016/j.humpath.2013.05.010. Epub 2013 Jul 12.

Abstract

Trefoil factor 3 (TFF3) is associated with various cancers and overexpressed in a subset of prostate cancers. Functional studies suggest that v-ets erythroblastosis virus E26 oncogene homolog (avian) (ERG) down-regulates TFF3 expression in hormone-naïve prostate cancer. To characterize this inverse relationship, we developed a triple immunostain encompassing ERG, TFF3, and high-molecular-weight cytokeratin. Triple stain was performed on 96 tumors and 52 benign cases represented in tissue microarrays. Distinct ERG and TFF3 protein was expressed in 45% (43/96) and 36% (35/96) of prostate cancers, respectively. Coexpression was observed in 5% (5/96) of tumor cases, and 24% (23/96) did not express ERG or TFF3. The inverse expression of ERG and TFF3 was significant (P < .0001), with 57% (30/53) of ERG-negative tumors demonstrating TFF3 expression. Sensitivity and specificity of combined ERG and TFF3 expression in detecting prostate cancer were 76% and 96%, respectively. The feasibility of triple immunostain protocol was validated in a set of 76 needle biopsies. The application of this multiplex in situ biomarker for molecular characterization of prostate cancer and as a supplemental diagnostic and prognostic tool in prostate needle biopsies should be further explored.

Keywords: Biomarker; ERG; FISH; H&E; HGPIN; HMWCK; IHC; Prostate cancer; TFF3; TMA; TMPRSS2; fluorescence in situ hybridization; hematoxylin and eosin; high-grade prostatic intraepithelial neoplasia; high-molecular-weight cytokeratin; immunohistochemistry; siRNA; small interfering RNA; tissue microarray; transmembrane protease, serine 2; trefoil factor 3; v-ets erythroblastosis virus E26 oncogene homolog (avian).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adenocarcinoma / metabolism
  • Adenocarcinoma / pathology*
  • Adult
  • Aged
  • Biomarkers, Tumor / metabolism*
  • Humans
  • Keratins / metabolism*
  • Male
  • Middle Aged
  • Molecular Weight
  • Peptides / metabolism*
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / pathology*
  • Tissue Array Analysis
  • Trans-Activators / metabolism*
  • Transcriptional Regulator ERG
  • Trefoil Factor-3

Substances

  • Biomarkers, Tumor
  • ERG protein, human
  • Peptides
  • TFF3 protein, human
  • Trans-Activators
  • Transcriptional Regulator ERG
  • Trefoil Factor-3
  • Keratins