Renal Function Parameters in Distinctive Molecular Subtypes of Prostate Cancer

SIMPLE SUMMARY: Prostate cancer is a malignancy with varying clinical outcomes, and monitoring renal function is crucial for patient care. Our study investigates the relationship between renal function and distinct molecular subtypes of prostate adenocarcinomas. We analyzed 72 patients with prostate cancer and chronic kidney disease who underwent radical prostatectomy. We categorized patients based on molecular markers and found that the ERG+/SPINK1+ subgroup had higher postoperative kidney disease stages and serum creatinine levels compared to the ERG+/SPINK1− subgroup, suggesting a connection between SPINK1 overexpression and kidney function. The HOXB13 −/TFF3+ subgroup exhibited higher preoperative serum creatinine levels and kidney disease stages than the HOXB13−/TFF3− subgroup, implying a role for TFF3 in kidney function. Furthermore, our study revealed links between kidney disease stages and prognostic grade groups in different molecular subtypes, highlighting the complex interplay between kidney function and tumor behavior. Our research underscores the importance of considering molecular subtypes in prostate cancer management. ABSTRACT: Prostate cancer is a prevalent malignancy in male patients, having diverse clinical outcomes. The follow-up of patients diagnosed with prostate cancer involves the evaluation of renal function, because its impairment reduces patient survival rates and adds complexity to their treatment and clinical care. This study aimed to investigate the relationship between renal function parameters and distinctive molecular subtypes of prostate adenocarcinomas, defined by the immunoexpression of the SPINK1, ERG, HOXB13, and TFF3 markers. The study group comprised 72 patients with prostate cancer and associated chronic kidney disease (CKD) who underwent radical prostatectomy. Histopathological, molecular, and renal parameters were analyzed. Patients were categorized based on ERG/SPINK1 and HOXB13/TFF3 status, and correlations with renal function and prognostic grade groups were assessed. The ERG+/SPINK1+ subgroup exhibited significantly higher postoperative CKD stages and serum creatinine levels compared to the ERG+/SPINK1− subgroup. This suggests an intricate relationship between SPINK1 overexpression and renal function dynamics. The HOXB13−/TFF3+ subgroup displayed higher preoperative serum creatinine levels and CKD stages than the HOXB13−/TFF3− subgroup, aligning with TFF3’s potential role in renal function. Furthermore, the study revealed associations between CKD stages and prognostic grade groups in different molecular subtypes, pointing out an intricate interplay between renal function and tumor behavior. Although the molecular classification of prostate acinar ADK is not yet implemented, this research underscores the variability of renal function parameters in different molecular subtypes, offering potential insights into patient prognosis.