Abstract. Cofilin 1 (CFL1) is a cytoskeletal protein and overexpression of the protein has been associated with aggressiveness in certain types of malignancies. The aim of the present study was to investigate the clinical implications of CFL1 expression in prostate cancer (PCa). Immunohistochemical analysis was performed using formalin-fixed paraffin-embedded tissue sections obtained from 111 patients with PCa and 47 patients with benign prostatic hyperplasia (BPH). In total, 78 (70.3%) out of 111 PCa tissues were found to express the CFL1 protein, while no expression was detected in BPH tissues. In addition, CFL1 was also observed to be significantly associated with the Gleason score (GS; <7 vs. ≥7; P<0.0001) and presence of lymph node metastasis (presence vs. absence; P<0.0001). However, there was no association between the expression of CFL1 and other clinicopathological variables, such as age (<69 years vs. ≥69 years; P= 0.54), pre-operative prostate specific antigen level (<20 ng/ml vs. ≥20 ng/ml; P= 0.45) and pathological stage (T2 vs. ≥T3a; P= 0.055). In addition, 35 tissues (31.5%) were observed to possess a CFL1-positive mesenchyme. CFL1 expression was revealed to be an independent predictive factor for a high GS. The status of CFL1 expression in the mesenchyme also found to individually predict extraprostatic extension in PCa patients, based on multivariate analysis. The results of the present study indicated that CFL1 may specifically predict the development of PCa, and that the expression of CFL1 in the mesenchyme may be closely associated with the development of lymph node metastasis.
IntroductionProstate cancer (PCa) is one of the most common non-cutaneous malignancies in males. Since the introduction of the prostate specific antigen (PSA)-based screening strategy in clinical practice, a marked increase in the incidence of PCa has been observed (1). Although the use of this screening strategy has resulted in a 40% reduction in PCa-associated mortality, the majority of patients succumb to the disease once metastasis has occurred. In addition, overtreatment of indolent PCa has emerged. This phenomenon may account for the deficiencies in accurate diagnosis and risk stratification. Therefore, the identification and validation of novel biomarkers for PCa should be considered a priority (2).Cofilin 1 (CFL1) is the non-muscle isoform of the product of the CFL1 gene (Gene ID, 1072). CFL1 is a small ubiquitous protein that is able to bind monomeric globular (G) and filamentous actin and inhibits the polymerization of monomeric G-actin in a pH-dependent manner (3), playing a key role in cell migration and cytokinesis (4). This protein is reported to be directly associated with the invasion, metastasis and chemoresistance of various human malignant solid tumors (5,6). However, no previous studies regarding CFL1 expression and its association with clinicopathological features in PCa are available in the literature. The expression of CFL1 and its clinical implications in PCa are investigated in the present stud...