Relationship Between Stage-specific Embryonic Antigen-4 and Anti-cancer Effects of Neoadjuvant Hormonal Therapy in Prostate Cancer

Anticancer Res. 2020 Oct;40(10):5567-5575. doi: 10.21873/anticanres.14569.


Background/aim: Stage-specific embryonic antigen-4 (SSEA-4) expression is associated with malignant aggressiveness and is useful as a marker for identifying cancer stem cells. Our aim was to assess the relationship between hormonal therapy and SSEA-4 expression in prostate cancer (PC).

Materials and methods: SSEA-4 expression in paired specimens from PC patients who underwent neoadjuvant hormonal therapy (NHT) and radical prostatectomy (60 pre-NHT specimens and 60 post-NHT specimens) was evaluated using immunohistochemistry. Proliferation index (PI) and apoptotic index (AI) were also evaluated.

Results: Post-NHT tissues had significantly elevated SSEA-4 expression whereas anti-tumor effects of NHT were inversely correlated with SSEA-4 expression level. SSEA-4 expression in post-NHT tissues was significantly associated with biochemical recurrence-free survival. SSEA-4 expression in the post-NHT tissues was positively associated with PI and negatively done with AI.

Conclusion: SSEA-4 is a potential therapeutic target for limiting the malignant potential in hormone-naïve PC when considering the use of NHT.

Keywords: SSEA-4; biochemical recurrence; histological effect; neoadjuvant hormonal therapy; prostate cancer.

MeSH terms

  • Aged
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Biomarkers, Tumor / genetics*
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplastic Stem Cells / metabolism
  • Neoplastic Stem Cells / pathology
  • Prostate / pathology
  • Prostatectomy
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / genetics
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery
  • Stage-Specific Embryonic Antigens / genetics*


  • Antineoplastic Agents, Hormonal
  • Biomarkers, Tumor
  • Stage-Specific Embryonic Antigens
  • stage-specific embryonic antigen-4