Open Access Research article

Prognostic value of stromal and epithelial periostin expression in human prostate cancer: correlation with clinical pathological features and the risk of biochemical relapse or death

Pier Vitale Nuzzo13, Alessandra Rubagotti13, Linda Zinoli13, Francesco Ricci3, Sandra Salvi2, Simona Boccardo2 and Francesco Boccardo13*

Author Affiliations

1 IRCCS San Martino University Hospital – IST National Cancer Research Institute and the University of Genoa, Academic Unit of Medical Oncology (UOC Oncologia Medica B), Largo Rosanna Benzi 10, 16132 Genoa, Italy

2 IRCCS San Martino University Hospital – IST National Cancer Research Institute, Pathology Unit, Genoa, Italy

3 University of Genoa, Department of Internal Medicine, School of Medicine, Genoa, Italy

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BMC Cancer 2012, 12:625  doi:10.1186/1471-2407-12-625

Published: 28 December 2012

Abstract

Background

The purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy.

Methods

Periostin (POSTN) expression in prostate cancer (PCa) and in normal specimens was evaluated in 90 patients by an immuno-reactive score(IRS) based on the intensity of immunostaining and on the quantity of stained cells. The t-test was applied to compare IRS values in cancer specimens to values in normal specimens. Pearson’s test was used to correlate POSTN expression to clinical pathologic features. PSA progression-free and survival curves were constructed by the Kaplan–Meier method and compared using the log-rank test. Multi-parametric models were constructed according to the Cox technique adding all the covariates predicting for either PSA progression or death into the models after univariate analysis.

Results

Both stromal and epithelial POSTN expression were significantly increased in tumor tissues. In particular, we found stromal expression to be significantly higher than epithelial expression as compared to normal tissues (p<0.000 and p=0.001).A significant correlation between POSTN epithelial expression and extra-prostatic extension was found (p=0.03). While high stromal expression was significantly associated with shorter survival (p=0.008), a low epithelial score significantly correlated with shorter PSA-free survival (p=0.04), suggesting that POSTN plays an apparently opposing biological role depending on its compartmentalization.Regardless of the mechanism that is involved, patients showing both high stromal and low epithelial expression made up a subgroup with a very bleak prognosis.

Conclusions

Although requiring further validation through larger studies, our findings show that POSTN might represent a novel prognostic marker for PCa.

Keywords:
POSTN protein; Human; Prostatic neoplasms; Extracellular matrix proteins; Prognosis; Biomarkers