SAM pointed domain-containing
Ets transcription factor (SPDEF), a member of the
ETS transcription factor family, has been associated with
prostate cancer development; however, its role in tumour development and progression is controversial. In the present study, SPDEF expression was analysed on a tissue microarray with >12,000
prostate cancer samples. SPDEF expression levels were higher in most
prostate cancer samples than in normal prostate epithelium, suggesting SPDEF was upregulated in
cancer. Nuclear SPDEF expression was identified in 80% of
prostate cancer samples, and considered weak in 26.4%, moderate in 40.1% and strong in 13.5% of cases. SPDEF positivity was significantly associated with tumour stage, Gleason grade,
lymph node metastasis and PSA recurrence (all P<0.0001). SPDEF overexpression was more common in ERG positive (94%) than in ERG negative
cancer (69%; P<0.0001). Elevated SPDEF expression predicted poor prognosis independent from established prognostic parameters, including Gleason grade, pT, pN, serum PSA level and nodal status (P<0.01). In summary, SPDEF overexpression was associated with aggressive behaviour, particularly in ERG negative
prostate cancer, and may have potential for clinical application.