Pd50-08 Clinically Significant Mri-Negative Prostate Cancer: A Matched-Paired Analysis to Evaluate Radiological, Histological and Molecular Features

You have accessJournal of UrologyProstate Cancer: Detection & Screening V (PD50)1 May 2024PD50-08 CLINICALLY SIGNIFICANT MRI-NEGATIVE PROSTATE CANCER: A MATCHED-PAIRED ANALYSIS TO EVALUATE RADIOLOGICAL, HISTOLOGICAL AND MOLECULAR FEATURES Marco Oderda, Alessandro Marquis, Luca Bertero, Giorgio Calleris, Marco Gatti, Giancarlo Marra, Alessandro Dematteis, Irene Ruggirello, Elena Vissio, Riccardo Faletti, Paola Cassoni, and Paolo Gontero Marco OderdaMarco Oderda , Alessandro MarquisAlessandro Marquis , Luca BerteroLuca Bertero , Giorgio CallerisGiorgio Calleris , Marco GattiMarco Gatti , Giancarlo MarraGiancarlo Marra , Alessandro DematteisAlessandro Dematteis , Irene RuggirelloIrene Ruggirello , Elena VissioElena Vissio , Riccardo FalettiRiccardo Faletti , Paola CassoniPaola Cassoni , and Paolo GonteroPaolo Gontero View All Author Informationhttps://doi.org/10.1097/01.JU.0001008620.35181.96.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A certain proportion of prostate cancers (PCa) is invisible to multiparametric MRI. The reason why some high-grade tumors are missed is still unknown and might be due to specific cytoarchitectural and genomic features. This study aims to better understand this open issue. METHODS: We retrospectively selected from our institutional radical prostatectomy (RP) database 33 patients with negative pre-biopsy MRI diagnosed with ISUP≥2 PCa between 2015 and 2020. After the revision by two dedicated uro-radiologists to rule out false negative cases, a final "MRI-invisible" cohort of 17 patients was obtained. A second case-control-matched "MRI-visible" cohort of 17 patients who underwent RP after a targeted+systematic biopsy positive only on the target was identified. Histopathological and transcriptomic analyses to assess differences in structural and gene expression (mRNA, using the NanoString nCounter technology) profiles were conducted by two dedicated uro-pathologists. RESULTS: None of the examined cytoarchitectural features were associated with MRI visibility. Histopathology of aggressive behavior, such as high grade, large size, and glomeruloid/cribriform pattern, was equally distributed. Genomic analysis tested a large panel of genes involved in oncogenic pathways and peritumoral microenvironment modulation. Taken individually, none of the genes in the panel presented significantly different expression between the two groups. However, amongst those with higher differential expression, genes involved in metastatic and organizational processes of the tumor microenvironment were observed. In addition, pathways involved in cell adhesion, extracellular matrix (ECM) remodeling, and tumor-microenvironment cross-talk were found upregulated in the MRI-invisible cohort. The two groups did not differ in terms of intrinsic genomic aggressiveness of tumors, whereas pathways of aggressive behavior, such as the Wnt pathway, were found upregulated in tumors with primary Gleason pattern 4 as compared to 3, irrespective of MRI visibility. CONCLUSIONS: No clear cytoarchitectural or genomic features explained the MRI-invisible status. However, MRI-invisible PCas were associated with genomic hallmarks involved in ECM remodeling and the cross-talk between the tumor and the peritumoral microenvironment, suggesting that the latter may have a central role in MRI visibility. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1060 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Marco Oderda More articles by this author Alessandro Marquis More articles by this author Luca Bertero More articles by this author Giorgio Calleris More articles by this author Marco Gatti More articles by this author Giancarlo Marra More articles by this author Alessandro Dematteis More articles by this author Irene Ruggirello More articles by this author Elena Vissio More articles by this author Riccardo Faletti More articles by this author Paola Cassoni More articles by this author Paolo Gontero More articles by this author Expand All Advertisement PDF downloadLoading ...