{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:29:48Z","timestamp":1789421388640,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate molecular, immunohistochemical, and radiological parameters associated with pathological upgrading in patients with ISUP Grade Group 1 (GG1) prostate cancer who underwent radical prostatectomy (RP).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 106 patients diagnosed with ISUP GG1 prostate adenocarcinoma via needle biopsy and treated with RP between 2012 and 2022 were retrospectively analyzed. Based on final pathology, patients were categorized into No Upgrade, Low\u2010risk Upgrade, and High\u2010risk Upgrade groups. Biopsy specimens were evaluated for PTEN, ERG, and Ki\u201067 expression and TMPRSS2\u2010ERG gene fusion status, while radiological parameters, including PI\u2010RADS v2.1 scores and ADC values (ADC\n tumor<\/jats:sub>\n and ADC\n ratio<\/jats:sub>\n ), were assessed based on preoperative multiparametric MRI.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n TMPRSS2\u2010ERG fusion positivity and elevated ERG expression were significantly more common in the High\u2010risk Upgrade group (\n p<\/jats:italic>\n \u2009<\u20090.01 and\n p<\/jats:italic>\n \u2009=\u20090.04, respectively). PI\u2010RADS scores showed a stepwise increase, and ADC\n tumor<\/jats:sub>\n values decreased across risk groups (\n p<\/jats:italic>\n \u2009=\u20090.01 and\n p<\/jats:italic>\n \u2009=\u20090.03). No significant differences were observed for PTEN loss, Ki\u201067 index, or ADC\n ratio<\/jats:sub>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Certain immunohistochemical, radiological, and molecular parameters may be predictive of pathological upgrading in GG1 prostate cancer. Incorporation of these biomarkers into diagnostic evaluation and treatment planning may aid in refining risk stratification and avoiding overtreatment in clinically indolent cases. Although ADC\n tumor<\/jats:sub>\n values were significantly associated with upgrading, their correlation with molecular markers such as PTEN, ERG, Ki\u201067, and TMPRSS2\u2010ERG fusion were not statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Project No: 2023TIPF001<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/iju.70346","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T04:20:47Z","timestamp":1768623647000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk\u2010Stratified Gleason Upgrading in\n ISUP<\/scp>\n Grade Group 1 Prostate Cancer: Combined Analysis of\n TMPRSS2<\/scp>\n \u2010\n ERG<\/scp>\n ,\n PTEN<\/scp>\n , Ki\u201067, and\n MRI<\/scp>\n \u2010Derived Apparent Diffusion Coefficient Values"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9310-9181","authenticated-orcid":false,"given":"Nursinem","family":"Alkan Vur\u011fun","sequence":"first","affiliation":[{"name":"Department of Medical Pathology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8294-558X","authenticated-orcid":false,"given":"Nilay","family":"\u015een T\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Medical Pathology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9196-964X","authenticated-orcid":false,"given":"Sercan","family":"Vur\u011fun","sequence":"additional","affiliation":[{"name":"Department of Radiology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7544-5731","authenticated-orcid":false,"given":"Ahmet Baki","family":"Ya\u011fc\u0131","sequence":"additional","affiliation":[{"name":"Department of Radiology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4309-2323","authenticated-orcid":false,"given":"Sinan","family":"\u00c7elen","sequence":"additional","affiliation":[{"name":"Department of Urology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8597-2081","authenticated-orcid":false,"given":"Mesut Berkan","family":"Duran","sequence":"additional","affiliation":[{"name":"Department of Urology Pamukkale University Denizli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"\u00dcropatoloji [in Turkish]. \u0130zmir","author":"Y\u00f6r\u00fcko\u011flu 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PI\u2010RADS Score Predicts ISUP Upgrading and Adverse Pathology at Radical Prostatectomy in Men With Biopsy ISUP 1 Prostate Cancer","volume":"31","author":"Dekalo S.","year":"2024","journal-title":"Canadian Journal of Urology"}],"container-title":["International Journal of 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