Detection And Its Clinical Significance Of Tmprss2-ETS Gene Fusion In Prostate Cancer

Objective:To detect the fusions between TMPRSS2and ETS related genes (ERG、ETV1and ETV4) in the prostate pathological tissue by FISH and to analyze the significance of TMPRSS2and ETS family genes fusion for the early diagnosis of prostate cancer.Methods:Prostatic histopathologic specimens from32patients who were treated in Department of urology, Affiliated Tumor Hospital of Guangxi Medical University were collected. All the specimens were acquired by transrectal prostate biopsy or transurethral resection of the prostate. All specimens were fixed with10%formalin and embedded in paraffin. In addition to the routine pathological examination in all the specimens, FISH was used sequentially to detect the fusions between TMPRSS2and ERG, ETV1, ETV4.Results:TMPRSS2gene and ERG gene fusion was detected in16of the patients. The final pathological diagnosis was PCa in15patients and nerve fiber sarcoma in a patients. In16FISH-negative patients, two were pathologically diagnosed as PCa and the other14patients, as BPH. Combined with the clinical data,4FISH positive patients were clinically diagnosed as PCa but routine pathologic examination could not confirm the diagnosis of PCa. We successfully performed laparoscopic radical prostatectomy resection on the patients. Postoperative pathologic diagnosis was PCa. The sensitivity of TMPRSS2-ETS gene fusion by FISH was88.89%(16/18) and the specificity was100%. The positive predictive value was100%and the negative predictive value was87.50%(14/16).Conclusion:The sensitivity of TMPRSS2-ETS gene fusion in the tissues of PCa is high (88.89%) and the specificity is100%. Especially the100%specificity have great significance in improving the accuracy of prostate biopsy and making an early diagnosis of PCa.