Neuropilin‑1 expression in primary and metastatic prostate cancer: Expression patterns and clinicopathological correlations

Despite significant advancements in prostate cancer (PCa) diagnostics, it remains a challenge for accurate diagnosis and effective treatment. The aging global population and the established correlation between PCa incidence and advancing age suggest an anticipated rise in cases. Traditional clinicopathological parameters, such as prostate-specific antigen (PSA) levels, Gleason Grade Group, and pT stage, highlight the need for novel biomarkers to improve prognostic accuracy and risk assessment. The present study investigated the role of neuropilin-1 (NRP-1) in PCa progression, with a focus on lymph node metastases. Findings reveal that higher NRP-1 expression is associated with a lower percentage of metastatic lymph nodes (9.5 vs. 15.0%; P=0.027) and significantly lower postoperative PSA levels (0.02 vs. 0.21 ng/ml, P=0.039), both considered favorable prognostic factors. These observations align with prior hypotheses suggesting that NRP-1's function may depend on its ligand, semaphoring 3A (SEMA3A) or vascular endothelial growth factor (VEGF), with SEMA3A exhibiting anti-tumoral properties in hormone-sensitive PCa. However, NRP-1 expression showed no correlation with key clinicopathological parameters, such as pT stage or Gleason score, nor did it influence 5-year survival rates. These results suggest that while NRP-1 has potential as a biomarker, its prognostic utility as a standalone factor remains limited. Further studies are warranted to validate these findings in larger cohorts and to explore the molecular mechanisms underlying NRP-1's role in PCa.