Clonal Evaluation of Prostate Cancer by ERG/SPINK1 Status to Improve Prognosis Prediction
Technical Report,17 Sep 2014,16 Sep 2015
University of Michigan Ann Arbor United States
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Prostate cancer is commonly multiclonal, meaning that most men with prostate cancer have multiple, genetically distinct cancers. Pathologists cannot assess clonality by routine microscopic evaluation, and hence multiclonality is not incorporated into routinely reported pathological parameters, such as the number of cores with cancer. Given the importance of routine pathological parameters in prostate cancer prognosis, the potential to refine these parameters through assessing multiclonality represents a major opportunity. Hence, the objectives of this proposal are to utilize dual ERGSPINK1 immunohistochemistry IHCwhich can identify clonal, mutually exclusive molecular subtypesto assess the frequency of multiclonality in key clinical scenarios at biopsy and resection and its impact on prognostic parameters. Herein we confirm multiclonality in key diagnostic scenarios, such as discontinuous involvement of a single biopsy core. We anticipate that continued investigation will demonstrate the importance of incorporating multifocality in routine pathology practice.