TMPRSS2:ETS Fusions and Clinicopathologic Characteristics of Prostate Cancer Patients from Eastern China

  • Dong, Jun (Department of Urology, Huadong Hospital, Fudan University) ;
  • Xiao, Li (Department of Pathology, Huadong Hospital, Fudan University) ;
  • Sheng, Lu (Department of Urology, Huadong Hospital, Fudan University) ;
  • Xu, Jun (Department of Urology, Huadong Hospital, Fudan University) ;
  • Sun, Zhong-Quan (Department of Urology, Huadong Hospital, Fudan University)
  • Published : 2014.04.01


TMPRSS2:ERG gene fusions in prostate cancer have a dominant prevalence of approximately 50.0%, but infomration is limited on differences among ethnic and geographical groups. Some studies focusing on Japanese and Korean patients reported a lower incidence. Investigations concerning Chinese revealed controversial results. We evaluated TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions in more than 100 Eastern Chinese prostate cancer patients. Paraffin blocks of needle biopsy and radical prostatectomy were collected from 91 and 18 patients respectively. All patients' clinicopathologic factors were gathered. TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay. TMPRSS2:ERG fusions was present in 14.3% biopsy specimens and 11.1% radical prostatectomy patients. Neither TMPRSS2:ETV1 nor TMPRSS2:ETV4 fusion was found in any case. Altogether, 13 (86.7%) TMPRSS2:ERG fusion positive cases possessed deletion pattern and 7 (46.6%) and insertion pattern. Some 5 cases had both deletion and insertion patterns. While 38.5% (5/13) patients with deletion pattern had distant metastasis, except for one metastatic case harboring both deletion and insertion, there were no patients with insertion pattern accompanied with metastasis. There were no differences between fusion positive and negative cases in the distribution of age, PSA, Gleason score and TNM stage. Eastern Chinese prostate cancer patients have a significantly low incidence of TMPRSS2:ERG fusion. They also lack TMPRSS2:ETV1 and TMPRSS2:ETV4 fusion. There are more deletion pattern than insertion pattern in TMPRSS2:ERG positive cases. Fusion positive and negative patients have no clinicopathologic factor differences.


Prostate cancer;Chinese;gene fusion;TMPRSS2;ETS


Supported by : Clinical Geriatric Medicine Foundation of Shanghai science and technology committee


  1. Wang J, Cai Y, Ren C, Ittmann M (2006). Expression of variant TMPRSS2/ERG fusion messenger RNAs is associated with aggressive prostate cancer. Cancer Res, 66, 8347-51.
  2. Soller MJ, Isaksson M, Elfving P, et al (2006). Confirmation of the high frequency of the TMPRSS2/ERG fusion gene in prostate cancer. Genes Chromosomes Cancer, 45, 717-9.
  3. Sun QP, Li LY, Chen Z, et al (2010). Detection of TMPRSS2-ETS fusions by a multiprobe fluorescence in situ hybridization assay for the early diagnosis of prostate cancer: a pilot study. J Mol Diagn, 12, 718-24.
  4. Tomlins SA, Bjartell A, Chinnaiyan AM, et al (2009). ETS gene fusions in prostate cancer: from discovery to daily clinical practice. Eur Urol, 56, 275-86.
  5. Tomlins SA, Rhodes DR, Perner S, et al (2005). Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer. Science, 310, 644-8.
  6. Wang JJ, Liu YX, Wang W et al (2012). Fusion between TMPRSS2 and ETS family members (ERG, ETV1, ETV4) in prostate cancers from northern China. Asian Pac J Cancer Prev, 13, 4935-8.
  7. Xiang H, Ling ZX, Sun K, et al (2011). Detection and significance of fusion gene between TMPRSS2 and ETS transcription factor genes in fresh prostatic cancer tissues in Chinese patients. Zhonghua Bing Li Xue Za Zhi, 40, 187-8.
  8. Meiers I, Waters DJ, Bostwick DG (2007). Preoperative prediction of multifocal prostate cancer and application of focal therapy: Review 2007. Urology, 70, 3-8.
  9. Magi-Galluzzi C, Tsusuki T, Elson P, et al (2011). TMPRSS2-ERG gene fusion prevalence and class are significantly different in prostate cancer of Caucasian, African-American and Japanese patients. Prostate, 71, 489-97.
  10. Mao X, Yu Y, Boyd LK, et al (2010). Distinct genomic alterations in prostate cancers in Chinese and Western populations suggest alternative pathways of prostate carcinogenesis. Cancer Res, 70, 5207-12.
  11. Mehra R, Han B, Tomlins SA, et al (2007). Heterogeneity of TMPRSS2 gene rearrangements in multifocal prostate adenocarcinoma: Molecular evidence for an independent group of diseases. Cancer Res, 67, 7991-5.
  12. Miyagi Y, Sasaki T, Fujinami K, et al (2010). ETS family-associated gene fusions in Japanese prostate cancer: analysis of 194 radical prostatectomy samples. Mod Pathol, 23, 1492-8.
  13. Mosquera JM, Mehra R, Regan MM, et al (2009). Prevalence of TMPRSS2-ERG fusion prostate cancer among men undergoing prostate biopsy in the United States. Clin Cancer Res, 15, 4706-11.
  14. Rawal S, Young D, Williams M, et al (2013). Low frequency of the ERG oncogene alterations in prostate cancer patients from India. J Cancer, 4, 468-72.
  15. Ren S, Peng Z, Mao JH, et al (2012). RNA-seq analysis of prostate cancer in the Chinese population identifies recurrent gene fusions, cancer-associated long noncoding RNAs and aberrant alternative splicing. Cell Res, 22, 806-21.
  16. Rubin MA, Maher CA, Chinnaiyan AM (2011). Common gene rearrangements in prostate cancer. J Clin Oncol, 29, 3659-68.
  17. Sim HG, Cheng CW (2005). Changing demography of prostate cancer in Asia. Eur J Cancer, 41, 834-45.
  18. Dai MJ, Chen LL, Zheng YB, et al (2008). Frequency and transcript variant analysis of gene fusions between TMPRSS2 and ETS transcription factor genes in prostate cancer. Zhonghua yi xue za zhi, 88, 669-73.
  19. Barry M, Perner S, Demichelis F, Rubin MA (2007). TMPRSS2-ERG fusion heterogeneity in Multifocal prostate cancer: Clinical and biologic implications. Urology, 70, 630-3.
  20. Cerveira N, Ribeiro FR, Peixoto A, et al (2006). TMPRSS2-ERG gene fusion causing ERG overexpression precedes chromosome copy number changes in prostate carcinomas and paired HGPIN lesions. Neoplasia, 8, 826-32.
  21. Clark J, Attard G, Jhavar S, et al (2008). Complex patterns of ETS gene alteration arise during cancer development in the human prostate. Oncogene, 27, 1993-2003.
  22. Furusato B, Gao CL, Ravindranath L, et al (2008). Mapping of TMPRSS2-ERG fusions in the context of multi-focal prostate cancer. Modern Pathol, 21, 67-75.
  23. Furusato B, van Leenders GJ, Trapman J, et al (2011). Immunohistochemical ETS-related gene detection in a Japanese prostate cancer cohort: diagnostic use in Japanese prostate cancer patients. Pathol Int, 61, 409-14.
  24. Gronberg H (2003). Prostate cancer epidemiology. Lancet, 361, 859-64.
  25. Hessels D, Smit FP, Verhaegh GW, et al (2007). Detection of TMPRSS2: ERG fusion transcripts and prostate cancer antigen 3 in urinary sediments may improve diagnosis of prostate cancer. Clin Cancer Res, 13, 5103-8.
  26. Lee K, Chae JY, Kwak C, Ku JH, Moon KC (2010). TMPRSS2-ERG gene fusion and clinicopathologic characteristics of Korean prostate cancer patients. Urology, 76, 7-13.
  27. Attard G, Reid AH, Yap TA, et al (2008). PhaseⅠclinical trial of a selective inhibitor of CYP17, abiraterone acetate, confirms that castration-resistant prostate cancer commonly remains hormone driven. J Clin Oncol, 26, 4563-71.

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