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

Objectives To investigate the relationship between periprostatic adipose tissue (PPAT) adipokine expression and prostate cancer (PCa) aggressiveness using both pathological features of radical prostatectomy (RP) and multiparametric magnetic resonance imaging ( MRI) variables. Patients and Methods Sixty-nine men were recruited to assess immunohistochemical expression of tumour necrosis factor (TNF)alpha and vascular endothelial growth factor (VEGF) of periprostatic fat of RP specimens. Per cent immunopositivity was quantified on scanned slides using the Aperio Positive Pixel Count algorithm for PPAT TNF alpha, 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 normalized to prostate volume (PV) to account for variations in PV (normalized PFV = PFV/PV). MRI quantitative values (K-ep, K-trans and apparent diffusion coefficient) were measured from the PCa primary lesion using Olea Sphere software. Patients were stratified into three groups according to RP Gleason score (GS): <= 6, 7(3 + 4) and >= 7(4 + 3). Results The mean rank of VEGF and TNF alpha was 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 TNF alpha (18.2 +/- 8.95) positivity than patients with stage pT(2) (13.27 +/- 10.66; t [67] = -2.03, P = 0.047). TNF alpha expression significantly correlated with K-trans (rho = 0.327, P = 0.023). TNF alpha (P = 0.043), and VEGF (P = 0.02) correlated with high grade PCa (GS >= 7) in RP specimens and also correlated significantly with upgrading of GS from biopsy to RP histology. Conclusions The expression levels of TNF alpha and VEGF on immunostaining significantly correlated with aggressivity of PCa. As biomarkers, these indicate the risk of having high grade PCa in men undergoing RP.