High level of Ets-related gene expression has high specificity for prostate cancer: a tissue microarray study of 11 483 cancers

Our plain-English summary of High level of Ets-related gene expression has high specificity for prostate cancer: a tissue microarray study of 11 483 cancers, by S. Minner, A.M. Luebke, M. Kluth, et al (Histopathology, 2012).

The study

• Authors: S. Minner, A.M. Luebke, M. Kluth, C. Bokemeyer, F. Jänicke, J. Izbicki, T. Schlomm, G. Sauter, W. Wilczak
• Journal: Histopathology
• Published: 2012;61(3):445-53
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aims: TMPRSS2-ERG fusion resulting in strong Ets-related gene (ERG) overexpression occurs in about 50% of prostate cancers. This study was undertaken to determine the prevalence of ERG overexpression in other tumour types as well as in normal tissues.

Methods And Results: A total of 11 483 tumours and 72 different normal tissue types were analysed in a tissue microarray format. Strong nuclear ERG overexpression was found in 36.7% of prostate carcinomas as well as in various vascular tumours, including Kaposi sarcomas (91.7%), angiosarcomas (100%) and haemangiomas (90.9%). Moderate to strong nuclear ERG immunostaining was also observed in thymoma (6.1%). Weak to moderate ERG staining was found in a small number of squamous cell carcinomas of the skin, squamous carcinomas of the lung, malignant mesotheliomas, carcinosarcomas of the uterus, gastrointestinal stromal tumours, hepatocellular carcinomas, teratomas of the testis, anaplastic carcinomas of the thyroid, giant cell tumours of the tendon sheath and benign fibrous histiocytomas of the skin. ERG overexpression was not seen in 8886 samples from 132 other tumour types and subtypes. Within normal tissues, immunohistochemically detectable ERG overexpression was restricted to endothelial cells and subsets of lymphocytes.

Conclusions: The high specificity of ERG expression in both normal and neoplastic tissues suggests a very narrow biological role for ERG in highly selected tissues.

© 2012 Blackwell Publishing Ltd.

In plain English

This laboratory study from the University Medical Center Hamburg-Eppendorf in Germany did not examine asbestos exposure. The authors used tissue microarrays (slides holding small samples from many tumours) to test where a protein called ERG (Ets-related gene) appears. They analysed a total of 11 483 tumours and 72 normal tissue types. In normal tissues, strong ERG staining was seen only in endothelial cells, which line blood vessels, and in a subset of lymphocytes. ERG staining was found in 62 of 169 (36.7%) prostate cancers. It was also found in three types of vascular tumour, Kaposi sarcomas (91.7%), angiosarcomas (100%) and haemangiomas (90.9%), and in two of 33 thymomas (6.1%). Weak to moderate staining appeared in small numbers of several other tumour types. Among malignant mesotheliomas, one of 49 (2.0%) stained. The article does not say whether the mesotheliomas were pleural or peritoneal. Large groups of colon and breast cancers (more than 800 tumours per category) showed no positive case. The authors concluded that ERG expression has high specificity for prostate carcinoma. They noted that faint staining might be a technical artefact.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory tissue microarray study using immunohistochemistry (antibody staining) on pre-existing tissue samples
• Who was studied: 11 483 tumour samples from pre-existing tissue microarrays made by the authors' group in Hamburg, Germany, plus a normal tissue microarray of 72 tissue types (eight samples each from eight donors); dates of collection not given
• Exposure: No asbestos or other environmental or occupational exposure was studied; the study measured nuclear ERG protein staining with an antibody (clone EPR3864), scored for intensity from 0 to 4
• Main results:
  • In normal tissues, strong nuclear ERG staining was seen only in endothelial cells and in lymphocytes that appeared to be T lymphocytes
  • Prostate carcinomas: ERG staining in 62 of 169 (36.7%)
  • Three types of vascular tumour showed ERG staining in a high proportion: Kaposi sarcomas 91.7%, angiosarcomas 100%, haemangiomas 90.9%. The single evaluable epithelioid haemangioma was listed among ERG-negative tumours.
  • Thymomas: moderate to strong ERG staining in two of 33 (6.1%)
  • Malignant mesotheliomas: weak to moderate ERG staining in one of 49 (2.0%); the figure caption describes the mesothelioma staining as weak
  • Large groups of colon and breast cancers (more than 800 tumours per category) showed no ERG-positive case
• The authors' conclusion: The authors concluded that ERG expression has high specificity for prostate carcinoma, and that its potential as a diagnostic biomarker or therapeutic target remains to be evaluated
• Limitations the authors state:
  • The staining method used is not optimal for measuring protein amounts on a linear scale
  • Faint staining seen in other tumour types might be a technical artefact
  • ERG identifies only up to about 50% of prostate carcinomas, and weak staining in some prostate cancers overlaps with weak staining in other tumours

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Sarcoma, Squamous Cell Carcinoma, Malignant Mesothelioma.

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