Despite the lack of association between different genotypes and the presence of prostate cancer, endothelial nitric oxide synthase a/b (eNOS4a/b) polymorphism may be associated with advanced clinical stage and bone metastasis.

OBJECTIVES: To investigate the relationship between the distribution of endothelial NO synthase (eNOS4a/b) gene polymorphism and clinical features of prostate cancer (PCa). METHODS AND MATERIALS: One hundred thirty-two patients with PCa (mean age 64.10 ± 7.23 years) and 158 healthy controls (mean age 62.50 ± 7.53 years) with normal serum total prostate specific antigen (PSA) levels (<4 ng/ml) and digital rectal examinations (DRE) were enrolled in this prospectively designed study. PCa patients were classified as clinical T1 and T2 stages (Group 1), clinical T3 and T4 stages without bone metastasis (Group 2), and patients with bone metastasis (Group 3). Genotypes (aa, bb, ab) for eNOS4a/b gene polymorphisms were identified by polymerase chain reaction analysis. Meanwhile, plasma nitrate and nitrite levels (NO(x)) were used to estimate the amounts of endogenous NO formation for both groups of patients. RESULTS: Despite lack of statistically significant differences between PCa patients and the control group in terms of distribution of genotypes and frequency of alleles, plasma NO(x) levels were found to be significantly increased in PCa patients compared with controls. Meanwhile, there was no significant difference between the group of PCa patients with high and low grade tumors (Gleason score ≥ 7 vs. < 7) in terms of genotype (aa + ab genotypes or a-allele vs. bb genotype) distribution. However, bb genotype was observed to be present at a higher frequency (85.1% vs. 60%) in Group 1; whereas a-allele was more frequent in Group 2 (13.3% vs. 5.7%) and Group 3 (26.7 vs. 9.2). In addition, patients with a-allele had a 3.79-fold risk of having advanced disease and bone metastasis in comparison with bb genotype. Moreover, multivariable logistic regression analysis revealed that eNOS4a/b polymorphism and plasma NOx levels were predictive factors for developing bone metastasis and high stage disease after adjustment for age and BMI. CONCLUSIONS: Our data did not reveal any relationship between any of these genotypes and the presence of PCa. However, the finding that PCa patients with bb genotype generally manifest localized disease and develop bone metastasis less frequently in comparison patients with a-allele may indicate an important role for this polymorphism in the molecular pathophysiology of PCa.

Early prediction of anastomotic leakage after colorectal surgery by measuring peritoneal cytokines: prospective study.

BACKGROUND: Anastomotic leakage (AL) is a major cause of postoperative mortality and morbidity in colorectal surgery. We investigated the early prediction of peritoneal cytokine levels in developing AL after colorectal surgery. METHODS: Thirty-four patients with colorectal carcinoma, who underwent elective surgery, were included prospectively. Peritoneal samples were collected on the fifth postoperative day and interleukin (IL)-6, IL-10 and tumor necrosis factor-alpha were measured. Patients were divided into two groups: those with clinical evidence of AL (group 1) and those without any evidence of AL (group 2). RESULTS: Of the 34 patients undergoing anastomoses, clinically evident AL occurred in 4 patients (11.7%). There was a positive correlation between AL and peritoneal cytokine levels and blood loss and operation time and hospital stay. Peritoneal cytokine levels were significantly higher in group 1 as compared to group 2. The significant increase in patients with AL was observed between peritoneal cytokine levels and the postoperative days. However, a significant decrease in patients without AL was observed. CONCLUSION: The peritoneal cytokine levels can be an additional diagnostic tool that can support the early prediction of AL in colorectal surgery.