Pure Small Cell Carcinoma of the Prostate: A Case Report and Literature Review

Primary small cell carcinoma of the prostate (SCPCa) is a rare pathologic entity with unique clinical features and a poor prognosis. We present a case of a patient diagnosed with pure SCPCa treated with a combined chemo-radiotherapeutic approach. Pathological findings showed that the neoplastic cells exhibited positivity for pancytokeratin, synaptophysin, thyroid transcription factor-1 and CD56. Immunostaining for prostate-specific antigen was negative, while serum prostate-specific antigen was within normal limits. We review the available literature to gain additional information about diagnosis, treatment and prognosis of pure SCPCa

Associations of angiogenesis-related proteins with specific prognostic factors, breast cancer subtypes and survival outcome in early-stage breast cancer patients. A Hellenic Cooperative Oncology Group (HeCOG) trial

<div><p>Several studies support an important role of angiogenesis in breast cancer growth and metastasis. The main objectives of the study were to investigate the immunohistochemical expression of vascular endothelial growth factor (VEGF) family ligands (VEGF-A and VEGF-C) and receptors (VEGFR1, VEGFR2 and VEGFR3) in breast cancer and their associations with clinicopathological parameters, cancer subtypes/subgroups and patient outcome. Formalin-fixed paraffin-embedded tumor tissue samples were collected from early-stage breast cancer patients treated with anthracycline-based chemotherapy within a randomized trial. Immunohistochemistry was performed on serial 2.5 μm thick tissue sections from tissue microarray blocks. High VEGF-A, VEGF-C, VEGFR1, VEGFR2 and VEGFR3 protein expression was observed in 11.8% (N = 87), 80.8% (N = 585), 28.1% (N = 202), 64.6% (N = 359) and 71.8% (N = 517) of the cases, respectively. Significant associations were observed among all proteins (all p-values <0.05), with the exception of the one between VEGF-C and VEGFR1 (chi-square test, p = 0.15). Tumors with high VEGF-A protein expression, as compared to tumors with low expression were more frequently ER/PgR-negative (33.3% vs. 20.8%, chi-square test, p = 0.009) and HER2-positive (44.8% vs. 20.6%, p<0.001). In addition, tumors with high VEGFR1 expression, were more frequently HER2-positive (32.8% vs. 19.6%, p<0.001), while tumors with high VEGFR3 expression were more frequently ER/PgR-negative (24.9% vs. 17.0%, p = 0.024) and HER2-positive (26.9% vs. 14.8%, p = 0.001). High VEGF-A and VEGF-C protein expression was associated with increased DFS in the entire cohort (HR = 0.57, 95% CI 0.36–0.92, Wald’s p = 0.020 and HR = 0.71, 95% CI 0.52–0.96, p = 0.025, respectively), as well as in specific subtypes/subgroups, such as HER2-positive (VEGF-A, HR = 0.32, 95% CI 0.14–0.74, p = 0.008) and triple-negative (VEGF-C, HR = 0.44, 95% CI 0.21–0.91, p = 0.027) patients. High vs. low VEGFR1 expression was an unfavorable factor for DFS in triple-negative patients (HR = 2.74, 95% CI 1.26–5.98, p = 0.011), whereas the opposite was observed among the ER/PgR-positive patients (HR = 0.69, 95% CI 0.48–0.98, p = 0.041). Regarding OS, high VEGF-C protein expression was associated with increased OS in the entire cohort (HR = 0.64, 95% CI 0.46–0.89, Wald’s p = 0.008), as well as in in specific subtypes/subgroups, such as ER/PgR-negative (HR = 0.37, 95% CI 0.20–0.71, p = 0.003) and triple-negative (HR = 0.42, 95% CI 0.19–0.90, p = 0.026) patients. In conclusion, high expression of angiogenesis-related proteins is associated with adverse clinicopathological parameters in early-stage breast cancer patients and may be surrogate markers of biologically distinct subgroups of ER/PgR-negative or triple-negative tumors with superior outcome. Further validation of our findings in independent cohorts is needed.</p></div

Basic patient and tumor characteristics in the entire cohort and by treatment arm (E-T-CMF, ET-CMF).

<p>Basic patient and tumor characteristics in the entire cohort and by treatment arm (E-T-CMF, ET-CMF).</p

Associations of angiogenesis-related proteins with specific prognostic factors, breast cancer subtypes and survival outcome in early-stage breast cancer patients. A Hellenic Cooperative Oncology Group (HeCOG) trial - Fig 2

<p>Kaplan-Meier curves according to VEGF-A (A, B) and VEGF-C (C, D) protein expression (5-years DFS ROC curve cut-off). A, C: DFS; B, D: OS.</p

Primary antibodies, clone, source, dilution and staining conditions used in the present study.

<p>Primary antibodies, clone, source, dilution and staining conditions used in the present study.</p

Hazard ratios and 95% CIs estimated from age-adjusted and multivariable-adjusted^* Cox regression analyses with respect to DFS for the high vs. low expression of each of the angiogenesis-related proteins in the entire cohort and in selected subgroups.

<p>Hazard ratios and 95% CIs estimated from age-adjusted and multivariable-adjusted^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0200302#t003fn001" target="_blank">*</a>} Cox regression analyses with respect to DFS for the high vs. low expression of each of the angiogenesis-related proteins in the entire cohort and in selected subgroups.</p

Hazard ratios and 95% CIs estimated from age-adjusted and multivariable-adjusted^* Cox regression analyses with respect to OS for the high vs. low expression of each of the angiogenesis-related proteins in the entire cohort and in selected subgroups.

<p>Hazard ratios and 95% CIs estimated from age-adjusted and multivariable-adjusted^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0200302#t004fn001" target="_blank">*</a>} Cox regression analyses with respect to OS for the high vs. low expression of each of the angiogenesis-related proteins in the entire cohort and in selected subgroups.</p