Research Papers:

A novel non-canonical Wnt signature for prostate cancer aggressiveness

Elise Sandsmark _, Ailin Falkmo Hansen, Kirsten M. Selnæs, Helena Bertilsson, Anna M. Bofin, Alan J. Wright, Trond Viset, Elin Richardsen, Finn Drabløs, Tone F. Bathen, May-Britt Tessem and Morten B. Rye

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Oncotarget. 2017; 8:9572-9586. https://doi.org/10.18632/oncotarget.14161

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Elise Sandsmark1, Ailin Falkmo Hansen1, Kirsten M. Selnæs1, Helena Bertilsson2,3, Anna M. Bofin4, Alan J. Wright5, Trond Viset6, Elin Richardsen7,8, Finn Drabløs3, Tone F. Bathen1, May-Britt Tessem1,*, Morten B. Rye2,3,9,*

1Department of Circulation and Medical Imaging, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway

2Department of Urology, St. Olavs Hospital, Trondheim University Hospital, Norway

3Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway

4Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway

5Cancer Research UK Cambridge Institute, University of Cambridge, United Kingdom

6Department of Pathology and Medical Genetics, St. Olavs Hospital, Trondheim University Hospital, Norway

7Department of Medical Biology, UiT - The Arctic University of Norway, Tromsø, Norway

8Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway

9St. Olavs Hospital, Trondheim University Hospital, Norway

*These authors have contributed equally to this work

Correspondence to:

Elise Sandsmark, email: [email protected]

Morten B. Rye, email: [email protected]

Keywords: EMT, gene expression signature, biochemical recurrence, spectroscopy, MRSI

Received: August 26, 2016     Accepted: November 23, 2016     Published: December 24, 2016


Activation of the Canonical Wnt pathway (CWP) has been linked to advanced and metastatic prostate cancer, whereas the Wnt5a-induced non-canonical Wnt pathway (NCWP) has been associated with both good and poor prognosis. A newly discovered NCWP, Wnt5/Fzd2, has been shown to induce epithelial-to-mesenchymal transition (EMT) in cancers, but has not been investigated in prostate cancer. The aim of this study was to investigate if the CWP and NCWP, in combination with EMT, are associated with metabolic alterations, aggressive disease and biochemical recurrence in prostate cancer. An initial analysis was performed using integrated transcriptomics, ex vivo and in vivo metabolomics, and histopathology of prostatectomy samples (n=129), combined with at least five-year follow-up. This analysis detected increased activation of NCWP through Wnt5a/ Fzd2 as the most common mode of Wnt activation in prostate cancer. This activation was associated with increased expression of EMT markers and higher Gleason score. The transcriptional association between NCWP and EMT was confirmed in five other publicly available patient cohorts (1519 samples in total). A novel gene expression signature of concordant activation of NCWP and EMT (NCWP-EMT) was developed, and this signature was significantly associated with metastasis and shown to be a significant predictor of biochemical recurrence. The NCWP-EMT signature was also associated with decreased concentrations of the metabolites citrate and spermine, which have previously been linked to aggressive prostate cancer. Our results demonstrate the importance of NCWP and EMT in prostate cancer aggressiveness, suggest a novel gene signature for improved risk stratification, and give new molecular insight.

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