Periprostatic Fat Adipokines Expression Correlated with Prostate Cancer Aggressiveness in Men Undergoing Radical Prostatectomy for Clinically Localised Disease

Objectives: To investigate relationship between periprostatic adipose tissue (PPAT) adipokines expression and PCa aggressiveness using both pathological features of radical prostatectomy (RP) and multiparametric MRI parameters.

Patients and Methods: Sixty-nine men were recruited to assess immunohistochemical expression of TNFα- and VEGF of periprostatic fat of radical prostate specimens. Percent immunopositivity was quantified on scanned slides using Aperio Positive Pixel Count algorithm for PPAT TNFα, VEGF and androgen receptors. Periprostatic fat volume (PFV) was segmented on contiguous T 1 -weighted axial MRI slices from the level of the prostate base to apex. PFV was normalised to prostate volume (PV) to account for variations in PV (NPFV=PFV/PV). MRI quantitative values (K ep , K trans, and ADC) were measured from PCa primary lesion using OleaSphere software. Patients were stratified into three groups according to RP GS: ≤6, 7(3+4) and 7(4+3) or more.

Results: The mean rank of VEGF and TNFα were significantly different between the groups [H(2)= 11.038, p=0.004] and [H(2)=13.086, p=0.001], respectively. Patients with stage pT 3 had higher TNFα (18.2±8.95) positivity than patients with stage pT 2 (13.27±10.66), t (67) =-2.03, p=0.047. TNFα expression significantly correlated with K trans (ρ=0.327, p=0.023). TNFα (p=0.043) and VEGF (p= 0.02) correlates with high-grade PCa (GS≥7) in radical prostatectomy specimens and correlated significantly with upgradation of Gleason score from biopsy to radical prostatectomy histology.

Conclusions: Expression level of TNFα and VEGF on immunostaining significantly correlated with aggressivity of PCa. As biomarkers, these suggest the risk of having high-grade PCa in men undergoing RP. This article is protected by copyright. All rights reserved.