Prostate cancer is a heterogeneous disease that remains dormant for long periods or acts aggressively with poor clinical outcomes. Identifying aggressive prostate
tumor behavior using current glandular-focused histopathological criteria is challenging. Recent evidence has implicated the stroma in modulating prostate
tumor behavior and in predicting post-surgical outcomes. However, the emergence of stromal signatures has been limited, due in part to the lack of adoption of imaging modalities for stromal-specific profiling. Herein, label-free multiphoton microscopy (MPM), with its ability to image tissue with stromal-specific contrast, is used to identify prostate stromal features associated with aggressive
tumor behavior and clinical outcome. MPM was performed on unstained
prostatectomy specimens from 59 patients and on biopsy specimens from 17 patients with known post-surgery recurrence status. MPM-identified
collagen content, organization, and morphological
tumor signatures were extracted for each patient and screened for association with recurrent disease. Compared to
tumors from patients whose disease did not recur,
tumors from patients with recurrent disease exhibited higher MPM-identified
collagen amount and
collagen fiber intensity signal and width. Our study shows an association between MPM-identified stromal
collagen features of prostate
tumors and post-surgical disease recurrence, suggesting their potential for
prostate cancer risk assessment.