Open Access

ARTICLE

Alpha-dystroglycan staining pattern and mortality in patients undergoing radical prostatectomy with lymph node positive prostate cancer

Ahmad N. Alzubaidi¹, Kenneth G. Nepple¹, Annah Vollstedt¹, Laila Dahmoush³, Deqin Ma³, Michael D. Henry^1,2,3,4, James A. Brown^1,4

1 Department of Urology, University of Iowa Health Care, Iowa City, Iowa, USA
2 Department of Molecular Physiology and Biophysics, University of Iowa Health Care, Iowa City, Iowa, USA
3 Department of Pathology, University of Iowa Health Care, Iowa City, Iowa, USA
4 Holden Comprehensive Cancer Center, Iowa City, Iowa, USA
Address correspondence to Dr. James Brown, Department of Urology,University of Iowa Carver College of Medicine, 3 Roy Carver Pavilion, 200 Hawkins Drive, Iowa City, IA 52242-1089 USA

Canadian Journal of Urology 2019, 26(6), 10054-10060.

Abstract

Introduction: Dystroglycan (DG) is a cell surface receptor for extracellular matrix proteins involved in tissue mechanical stability and matrix organization. Initial work has demonstrated that alpha-DG expression is decreased in many types of adenocarcinoma, including prostate, and potentially associated with the development of metastatic disease. However, the consistency between prostate and lymph node alpha-DG staining has not been previously reported. Additionally, identification of an immunohistochemical marker associated with prostate cancer grade, stage, need for adjuvant or salvage therapy, and mortality would have potential clinical value.
Materials and methods: Node-positive, margin-negative radical prostatectomy specimens from a single institution between 1982 and 2012 were reviewed, identifying 35 prostate specimens, including 26 patients with available tissue from both the primary prostatectomy and lymph node specimens. The expression levels of the alpha-DG subunit were analyzed using immunohistochemistry and graded from 0 to 4. Survival was compared among different staining pattern groups.
Results: Strength of alpha-DG staining was found to be consistent between prostate and lymph node specimens (p < 0.004). The median overall survival was shorter in those without alpha-DG staining in the prostate compared to those with positive staining, but this difference was not statistically significant (13.2 years versus 19.4 years, p = 0.21). Negative staining was associated with higher mean PSA, pathologic T stage, Gleason grade, and the need for adjuvant or salvage therapy compared to the positive group, but none reached statistical significance (16.06 ng/mL vs. 11.67 ng/mL, p = 0.79; 89% vs. 68%, p = 0.38; 33.3% vs. 23.1%, p = 0.66; 88.9% vs. 76.9%, p = 0.44).
Conclusions: DG expression by immunohistochemistry staining was consistent between prostate and metastatic lymph node specimens. In a small cohort of prostate cancer patients with margin-negative but node-positive disease, DG staining was not associated with Gleason grade or overall mortality.

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