Primary signet ring cell carcinoma of prostate (report of 2 cases)

Objective To study the clinical features of primary signet ring cell carcinoma of prostate. Methods 2 cases of primary signet ring cell carcinoma of the prostate were studied and reviewed. Results The age of the 2 patients was 64 and 73. The clinical symptoms were dysuria, vesical irritability and perineum discomfort. Histologically, signet ring cell carcinoma was composed of round cells with abundant clear cytoplasm and crescent-shaped nuclei on one side. Mitosis were frequently observed. Immunohistochemical testing showed the cancer cell was positive for prostate specific antigen (PSA.), prostate acid phosphatase ( PAP ), AR, cytokeratin and negative for caicinoernbryonic antigen (CEA), alcian blue/ periodic arid-schiff (AB/PAS). One case (stage D) died 6 months after bilateral orchiectomy and flutamide therapy because of wide-spead metastasis; the other (stage B2) has been surviving 25 months after radical prostatectomy, bilateral orchiectomy, endocrine therapy and local irradiation ministration.

Immunohistochemical analysis of PD-L1 and tumor-infiltrating immune cells expression in the tumor microenvironment of primary signet ring cell carcinoma of the prostate

Primary signet ring cell carcinoma(SRCC)of the prostate is a rare neoplasm.However,its potential tumorigenic mechanism,clinicopathological features,and prognostic outcome have not been systematically described.To determine the pathogenic mechanism,we detected distributions of programmed cell death-ligand 1(PD-L1),programmed death 1(PD-1),and cellular components in the tumor microenvironment,including tumor-infiltrating lymphocytes(CD4 and CD8),tumor-associated macrophages(TAMs;CD163 and CD68),and tumor-associated fibroblasts(vimentin and alpha-smooth muscle actin[α-SMA]),in tumor tissues from four patients with primary prostatic SRCC compared with corresponding adjacent tissues and tumor tissues from 30 patients with prostate adenocarcinoma(PCa)by immunohistochemical staining.We found higher expression of PD-L1,CD163,and CD68 in primary SRCC specimens than that in both corresponding adjacent nontumor specimens and PCa specimens with different Gleason scores,indicating that TAMs may participate in the malignant biological behavior of primary SRCC of the prostate.For further analysis,we searched electronic journal databases and Surveillance,Epidemiology,and End Results(SEER)to identify 200 eligible patients including our four cases.According to Kaplan–Meier survival curve analysis,patients<68 years old,with radical prostatectomy(RP),Gleason score of 7–8,and lower clinical stage had longer overall survival(OS).Moreover,Cox multivariate analysis indicated that race(hazard ratio[HR]=1.422),surgical approach(HR=1.654),and Gleason score(HR=2.162)were independent prognostic factors for OS.Therefore,primary SRCC of the prostate represents a distinct and aggressive subtype of prostate cancer associated with a higher distribution of PD-L1 and TAMs,which warrants further clinical investigation.