1. High CHK2 protein expression is a strong and independent prognostic feature in ERG negative prostate cancer
- Author
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Sarah Minner, Thorsten Schlomm, Andreas M. Luebke, Viktoria Chirico, Guido Sauter, Katharina Möller, Waldemar Wilczak, Hans Heinzer, Cornelia Schroeder, Alexander Haese, Hartwig Huland, Markus Graefen, Claudia Hube-Magg, Maximilian Lennartz, Patrick Lebok, Stefan Steurer, Simon Kind, Margit Fisch, Felix Federlein, Florian Lutz, Doris Höflmayer, Till Eichenauer, and Ronald Simon
- Subjects
0301 basic medicine ,Adult ,Male ,animal structures ,DNA repair ,environment and public health ,TMPRSS2 ,Pathology and Forensic Medicine ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Transcriptional Regulator ERG ,Prostate ,medicine ,Biomarkers, Tumor ,Humans ,Checkpoint Kinase 2 ,Aged ,Retrospective Studies ,Tissue microarray ,business.industry ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Prognosis ,enzymes and coenzymes (carbohydrates) ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cancer research ,biological phenomena, cell phenomena, and immunity ,Neoplasm Recurrence, Local ,business ,Erg ,Immunostaining - Abstract
Checkpoint kinase 2 (CHK2) is a serine-threonine kinase with a role in DNA repair, cell cycle arrest or apoptosis in response to DNA damage. Both reduced and increased CHK2 expression has been described in different tumour types with impact on patient prognosis. To evaluate prevalence and significance of altered CHK2 expression in prostate cancer, a tissue microarray containing 17,747 tumours was analysed by immunohistochemistry. Nuclear CHK2 immunostaining was absent or weak in benign prostate epithelium but often more prominent in cancers. CHK2 immunostaining was considered weak in 38.8%, moderate in 33.6% and strong in 11.2% of prostate cancers. High CHK2 expression was strongly associated with TMPRSS2:ERG fusions (p0.0001). Subgroup analysis of ERG positive and negative cancers revealed that high CHK2 staining was significantly linked to advanced tumour stage, high Gleason score, positive nodal status, positive surgical margin, high preoperative PSA (p0.0001 each) and early prostate-specific antigen (PSA) recurrence (p=0.0001) in the subset of ERG negative cancers, while most of these associations were absent in ERG positive cancers. In ERG negative cancers, high CHK2 expression was an independent predictor of patient prognosis, even if parameters were included that were only available postoperatively. High CHK2 expression was also linked to presence of chromosomal deletions, high level of androgen receptor expression, positive p53 immunostaining, and high Ki-67 labelling index. These provide further in vivo evidence for previously described functional interactions. In summary, high CHK2 expression is linked to adverse tumour features and independently predicts early biochemical recurrence in ERG negative prostate cancer. CHK2 measurement, either alone or in combination, might be of clinical utility in this prostate cancer subgroup.
- Published
- 2019